title: Matted nodes as a predictor of distant metastasis in advanced-stage III/IV oropharyngeal squamous cell carcinoma.
abstract: BACKGROUND
  We recently described the imaging characteristics of multiple confluent regional metastases (matted nodes) and found that this characteristic was associated with distant metastasis in patients with oropharyngeal squamous cell carcinoma (SCC). The purpose of this study was to determine if matted nodes are a predictive marker for distant metastasis.
  
  
  METHODS
  Radiologic lymph node characteristics on 205 patients with untreated stage III/IV with oropharyngeal SCC of whom 192 had known human papillomavirus (HPV) status underwent weekly carboplatin and paclitaxel with concomitant intensity-modulated radiation therapy (IMRT) between 2003 and 2010 with a minimum of 2-year of follow-up.
  
  
  RESULTS
  The 3-year disease-specific survival (DSS) for patients with matted nodes was 58% versus 97% with nonmatted nodes (p = .0001). The prevalence of matted nodes in the population was 20%. The positive predictive value of matted nodes for distant metastasis was 66%, and the negative predictive value was 99%.
  
  
  CONCLUSIONS
  Matted nodes are a predictive marker for distant disease and can be used for planning new clinical interventions.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Spector
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Steven B
authors.initials: SB
authors.lastname: Chinn
authors.affiliation: Department of Biostatistics, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Emily
authors.initials: E
authors.lastname: Bellile
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: K Kelly
authors.initials: KK
authors.lastname: Gallagher
authors.affiliation: Department of Radiology, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Mohannad
authors.initials: M
authors.lastname: Ibrahim
authors.affiliation: Department of Radiation Oncology, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Vainshtein
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Chanowski
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Heather M
authors.initials: HM
authors.lastname: Walline
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Moyer
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Prince
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Wolf
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Carol R
authors.initials: CR
authors.lastname: Bradford
authors.affiliation: Department of Pathology, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: McHugh
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Thomas
authors.initials: T
authors.lastname: Carey
authors.affiliation: Department of Medical Oncology, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Francis P
authors.initials: FP
authors.lastname: Worden
authors.affiliation: Department of Radiation Oncology, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Avraham
authors.initials: A
authors.lastname: Eisbruch
authors.affiliation: Department of Otolaryngology, Department of Surgical Oncology, University of Toronto.
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Chepeha
mesh_terms: D015415:Biomarkers; D016190:Carboplatin / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D059248:Chemoradiotherapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000175:diagnosis*; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D017239:Paclitaxel / Q000627:therapeutic use; D011237:Predictive Value of Tests; D050397:Radiotherapy, Intensity-Modulated; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D016190:Carboplatin; D017239:Paclitaxel
keywords: biomarkers; distant metastasis; matted nodes; oropharyngeal squamous cell carcinoma; predictor; prognosis