Matted nodes as a predictor of distant metastasis in advanced-stage III/IV oropharyngeal squamous cell carcinoma

Head Neck. 2016 Feb;38(2):184-90. doi: 10.1002/hed.23882. Epub 2015 Jun 30.

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%.

Conclusion: Matted nodes are a predictive marker for distant disease and can be used for planning new clinical interventions.

Keywords: biomarkers; distant metastasis; matted nodes; oropharyngeal squamous cell carcinoma; predictor; prognosis.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Biomarkers
  • Carboplatin / therapeutic use
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / therapy
  • Chemoradiotherapy
  • Female
  • Follow-Up Studies
  • Humans
  • Lymph Nodes / pathology*
  • Male
  • Middle Aged
  • Neoplasm Metastasis / diagnosis*
  • Oropharyngeal Neoplasms / mortality
  • Oropharyngeal Neoplasms / pathology*
  • Oropharyngeal Neoplasms / therapy
  • Paclitaxel / therapeutic use
  • Predictive Value of Tests
  • Radiotherapy, Intensity-Modulated
  • Sensitivity and Specificity

Substances

  • Biomarkers
  • Carboplatin
  • Paclitaxel