Matted Nodes: Poor Prognostic Marker in Oropharyngeal Squamous Cell Carcinoma Independent of HPV and EGFR Status

Overview

Journal Head Neck

Specialties General Surgery
Oncology

Date 2012 Jan 17

PMID 22247002

Citations 30

Authors

Matthew E Spector

K Kelly Gallagher

Emily Light

Mohannad Ibrahim

Eric J Chanowski

Jeffrey S Moyer

Mark E Prince

Gregory T Wolf

Carol R Bradford

Kitrina Cordell

Jonathan B McHugh

Thomas Carey

Francis P Worden

Avraham Eisbruch

Douglas B Chepeha

Affiliations

Soon will be listed here.

Abstract

Background: Despite better prognosis, there is a group of oropharyngeal squamous cell carcinoma (SCC) human papillomavirus (HPV)+ patients who experience treatment failure and succumb to distant metastasis.

Methods: Seventy-eight previously untreated patients nested in a concurrent chemoradiation protocol were reviewed to correlate patterns of local-regional tumor extent to distant metastasis. Biomarker assessment was: HPV in situ hybridization and epidermal growth factor receptor (EGFR) immunointensity.

Results: The 3-year disease-specific survival (DSS) for patients presenting with and without matted nodes was 69% and 94%, respectively (p = .003). Matted nodes were a poor prognostic factor independent of T classification, HPV, EGFR, and smoking status. For patients who were HPV+, 7 of 11 died of distant metastasis and 6 of 7 with distant metastasis had matted nodes.

Conclusion: Matted nodes are a novel marker of poor prognosis in oropharyngeal SCC independent of established prognostic factors. Matted nodes may identify patients at risk for the development of distant metastasis who could benefit from systemic therapy, whereas patients without matted nodes may be candidates for de-escalation of therapy.

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