Retropharyngeal lymph node involvement in human papillomavirus–associated oropharyngeal squamous cell carcinoma

Abstract

4.

Radiographic retropharyngeal lymph node involvement in HPV‐associated oropharyngeal carcinoma: Patterns of involvement and impact on patient outcomes

“…With regard to oncologic outcomes, Tang et al demonstrated that RPLN involvement demonstrated a nonsignificant trend toward worse OS ( P = .08). Similarly, Baxter et al found increased odds of disease recurrence or death in patients with HPV‐associated OPC with radiographic RPLN involvement but this did not remain statistically significant in multivariate analysis . In contrast, Samuels et al found lower 5‐year rates of OS and increased distant failure in patients with RPLN involvement compared with those without, findings that maintained statistical significance on multivariate analysis …”

“…However, given that these patients had been treated prior to routine tumor HPV testing, the lack of tumor HPV status limited study conclusions. Since our initial publication, other single‐institution series evaluating patient outcomes for those specifically with HPV‐associated OPC and RPLN involvement have demonstrated mixed results …”

“…Since our initial publication, other single-institution series evaluating patient outcomes for those specifically with HPV-associated OPC and RPLN involvement have demonstrated mixed results. [3][4][5] Given the paucity and limited power of existing data and conflicting results regarding the impact of RPLN in patients with HPV-associated OPC, the current study was performed to: 1) characterize the incidence, patterns, and lymph node volume characteristics of RPLN involvement in patients with HPV-associated OPC; 2) assess the impact of RPLN involvement on oncologic outcomes and patterns of disease recurrence in patients with lymph node-positive (N+) OPC; 3) test the potential usefulness of RPLN status as a covariate to improve the predictive model performance of the current AJCC staging system; and 4) generate hypotheses for future investigation.…”

Transoral robotic retropharyngeal node dissection in oropharyngeal squamous cell carcinoma: Patterns of metastasis and functional outcomes

“…Metastasis to the RPLNs is not a rare event in oropharyngeal SCC, occurring in 13%–36% of patients in studies examining the RPLN via histopathology. It occurs most commonly in tumors of the tonsil and lateral pharyngeal wall and seldom in tumors of the base of tongue . Few studies of the diagnostic accuracy of the various imaging modalities for the detection of RPLN metastasis have been conducted in which pathologic confirmation was available .…”

“…The presence of retropharyngeal metastases has historically been associated with decreased local control and overall survival . However, several contemporary series have failed to demonstrate this effect, suggesting that multimodality treatment may mitigate the negative prognostic effect, or that the effect on prognosis may not be as significant in the human papillomavirus (HPV)‐positive oropharyngeal SCC population …”