The association between T-stage and clinical nodal metastasis In HPV-positive oropharyngeal cancer.
OBJECTIVE
To evaluate the association between T-stage and primary tumor subsite with clinical nodal metastasis in HPV-positive oropharyngeal squamous cell carcinomas.


METHODS
Retrospective medical record review.


METHODS
A retrospective analysis of all previously untreated patients with HPV-positive oropharyngeal squamous cell carcinoma evaluated by the senior author in a tertiary-care center over a 5-year period was performed. Medical records were evaluated for HPV status, clinical T-stage, clinical nodal stage, and anatomic location of primary oropharyngeal subsite.


RESULTS
83% (59/71) of patients presented with clinical nodal disease. T-stage was not associated with the absence of regional disease (cN0) in tonsillar complex or base of tongue cancers. However, early T1/T2 tonsillar complex cancers were less likely to present with cN2c disease compared to T3/T4 lesions (0% vs. 18-33%, p=0.03). Further, base of tongue cancers were more likely to present with cN2c disease compared to tonsillar complex tumors (35% vs. 7%, p=0.01).


CONCLUSIONS
In HPV-positive tonsillar complex cancers, T-stage does not appear to predict the presence of clinical nodal metastasis (N0 vs. N1-N3), but may predict the extent of metastasis when present. This association does not appear to affect base of tongue cancers. Further, base of tongue cancers have a greater incidence of cN2c disease compared to tonsillar complex cancers.
Department of Otolaryngology- Head and Neck Surgery, Medical University of South Carolina.
Amit J
AJ
Sood
Department of Otolaryngology- Head and Neck Surgery, Medical University of South Carolina.
Wesley
W
McIlwain
Department of Otolaryngology- Head and Neck Surgery, Medical University of South Carolina.
Brendan
B
O'Connell
Department of Otolaryngology- Head and Neck Surgery, Medical University of South Carolina.
Shaun
S
Nguyen
Department of Otolaryngology- Head and Neck Surgery, Medical University of South Carolina.
Jeffrey J
JJ
Houlton
Department of Otolaryngology- Head and Neck Surgery, Medical University of South Carolina. Electronic address: headneck@musc.edu.
Terry
T
Day
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000556:secondary*; D005260:Female; D005500:Follow-Up Studies; D052162:Human papillomavirus 16 / Q000302:isolation & purification*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000473:pathology* / Q000821:virology; D030361:Papillomavirus Infections / Q000473:pathology / Q000821:virology*; D011379:Prognosis; D012189:Retrospective Studies