title: Tumor volume as a predictor of survival in human papillomavirus-positive oropharyngeal cancer.
abstract: Increasing evidence exists that tumor volume may be a superior prognostic model than traditional TNM staging. It has been observed that oropharyngeal squamous cell carcinoma (oropharyngeal SCC) in the setting of human papillomavirus (HPV) positivity have a greater propensity for cystic nodal metastases, and, thus, presumably larger volume with relatively smaller primary tumors. The influence of HPV status on the predictive value of tumor volume is unknown.
  
  
  
  Fifty-three patients with HPV-positive oropharyngeal SCC were treated with definitive chemotherapy and intensity-modulated radiotherapy (IMRT).
  
  
  
  The estimated 2-year overall survival (OS) and disease-free survival (DFS) was 92.2% and 83.6%, respectively. Nodal classification did not predict OS (p = .096) or DFS (p = .170). Similarly, T classification did not predict OS (p = .057) or DFS (p = .309). Lower nodal volume was associated with greater DFS (p = .001).
  
  
  
  Nodal tumor volume was found to be predictive of DFS. DFS was best predicted by nodal gross tumor volume (GTV) at 24 months. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1613-E1617, 2016.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh, Medical Center, Eye and Ear Institute, Pittsburgh, Pennsylvania.
authors.forename: Kara S
authors.initials: KS
authors.lastname: Davis
authors.affiliation: Division of Otolaryngology - Head and Neck Surgery, National University Cancer Institute, Singapore.
authors.forename: Chwee Ming
authors.initials: CM
authors.lastname: Lim
authors.affiliation: Department of Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: David A
authors.initials: DA
authors.lastname: Clump
authors.affiliation: Department of Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Dwight E
authors.initials: DE
authors.lastname: Heron
authors.affiliation: Division of Hematology/Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: James P
authors.initials: JP
authors.lastname: Ohr
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh, Medical Center, Eye and Ear Institute, Pittsburgh, Pennsylvania.
authors.forename: Seungwon
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh, Medical Center, Eye and Ear Institute, Pittsburgh, Pennsylvania.
authors.forename: Umamaheswar
authors.initials: U
authors.lastname: Duvvuri
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh, Medical Center, Eye and Ear Institute, Pittsburgh, Pennsylvania.
authors.forename: Jonas T
authors.initials: JT
authors.lastname: Johnson
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh, Medical Center, Eye and Ear Institute, Pittsburgh, Pennsylvania.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Ferris
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000628:therapy / Q000821:virology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000175:diagnosis* / Q000628:therapy / Q000821:virology; D027383:Papillomaviridae; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D047368:Tumor Burden
keywords: human papillomavirus; intensity-modulated radiotherapy (IMRT); neoplasm staging; oropharyngeal cancer; tumor burden