Oncologic outcomes of extended neck dissections in human papillomavirus-related oropharyngeal squamous cell carcinoma

Head Neck. 2018 May;40(5):955-962. doi: 10.1002/hed.25060. Epub 2018 Jan 29.

Abstract

Background: Oncologic outcomes of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (SCC) requiring resection of major muscular or neurovascular tissue during neck dissection for invasive nodal disease remain uncertain.

Methods: Patients with HPV-related oropharyngeal SCC requiring resection of major muscular or neurovascular tissue during their neck dissections were retrospectively identified.

Results: Seventy-two patients were included. Regional and distant recurrences occurred in 6% and 17% of patients. Advanced T classification, pathological node number of 5 or more, and omission of adjuvant therapy were associated with decreased disease-free survival (DFS). The addition of adjuvant chemotherapy was not associated with improved survival.

Conclusion: Patients with invasive nodal disease from HPV-related oropharyngeal SCC can be managed with up-front surgery and adjuvant therapy, as indicated with good regional control. Although distant recurrence was the primary site of failure, adjuvant chemotherapy was not associated with improved outcomes. The T classification, node number, and adjuvant radiotherapy are independent prognostic factors in this patient population.

Keywords: extralymphatic; human papillomavirus; neck dissection; oncologic outcomes; oropharynx.

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / surgery*
  • Carcinoma, Squamous Cell / virology*
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neck Dissection*
  • Oropharyngeal Neoplasms / mortality
  • Oropharyngeal Neoplasms / surgery*
  • Oropharyngeal Neoplasms / virology*
  • Papillomaviridae
  • Papillomavirus Infections / complications*
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome