Prognostic Value of Pathologically Positive Nodal Number in p16-Negative Oropharyngeal and Hypopharyngeal Squamous Cell Carcinoma with pN3b Status

Abstract

In this study, we aimed to investigate the prognostic value of the number of pathologically positive nodes (pN+) in p16-negative oropharyngeal (OPSCC) and hypopharyngeal (HPSCC) squamous cell carcinoma cases with pN3b status after surgery. We reviewed the clinical and pathological features of 120 newly diagnosed p16-negative OPSCC and HPSCC patients with pN3b status after radical surgery. The primary endpoints were the 5-year overall survival (OS), cancer-specific survival (CSS), and their prognostic factors. We used the Cox proportional hazards model for survival analysis. We generated predictive nomograms that incorporated the clinicopathological factors of OS and CSS. The 5-year OS and CSS rates were 44.1% and 59.1%, respectively. The optimal number of pN+ to predict the 5-year OS and CSS was pN+ = 3. In the Cox model, we observed that pN+ ≥ 3 was a significantly negative predictor of OS (HR: 1.9, 95% CI: 1.1–3.2, p = 0.021) and CSS (HR: 2.3; 95% CI: 1.2–4.6; p = 0.015). After adding the pN+ variable, the c-index of the predictive nomogram incorporating assorted clinicopathological factors increased from 0.66 to 0.689 for OS and from 0.713 to 0.75 for CSS. The results highlight the prognostic value of the pN+ number in p16-negative OPSCC and HPSCC patients with pN3b status.

Prediction of Occult Contralateral Nodal Metastasis in Surgical Treated p16 Negative Oropharyngeal Squamous Cell Carcinoma

“…[1][2][3] The presence of neck lymph node metastasis is one of the most significant prognostic factors in treating patients with OPSCC. 4,5 The chance of nodal metastasis is high in every tumor stage among patients with tonsil cancer. 6 In addition, the occult nodal metastasis rate of the ipsilateral side in OPSCC is approximately 30%, warranting the importance of neck treatment.…”