Low-risk human papilloma virus positive oropharyngeal cancer with one positive lymph node: Equivalent outcomes in patients treated with surgery and radiation therapy versus surgery alone

Reilly A. Sample, Carey Burton Wood, Angela L. Mazul, Thomas F. Barrett, Randal C. Paniello, Jason T. Rich, Stephen Y. Kang, Jose Zevallos, Mackenzie D. Daly, Wade L. Thorstad, Stephanie Y. Chen, Patrik Pipkorn, Ryan S. Jackson, Sidharth V. Puram

Research output: Contribution to journalArticlepeer-review

Abstract

Background: For human papilloma virus positive (HPV+) oropharyngeal squamous cell carcinoma (OPSCC), management recommendations for patients with a single metastatic lymph node <6 cm in diameter remain nebulous, leading to treatment heterogeneity in this common subgroup of patients. Methods: We utilized the National Cancer Database to perform survival and multivariable analyses of patients with HPV+ OPSCC with one positive lymph node <6 cm and negative surgical margins. Results: We found that 5-year survival is comparable between patients who receive surgery and adjuvant radiation versus surgery alone. In multivariable analyses, we found no significant difference in the hazard ratio of overall survival after adjusting for various potential confounders. Conclusions: These data suggest that patients with margin-negative HPV+ OPSCC with a single positive lymph node <6 cm have comparable survival with or without adjuvant radiation. Future studies exploring outcomes for this specific group in randomized-controlled trials will be critical for further evaluating these initial observations.

Original languageEnglish
Pages (from-to)1759-1768
Number of pages10
JournalHead and Neck
Volume43
Issue number6
DOIs
StatePublished - Jun 2021

Keywords

  • HPV
  • de-escalation
  • head and neck cancer
  • oropharyngeal cancer
  • radiation

Fingerprint

Dive into the research topics of 'Low-risk human papilloma virus positive oropharyngeal cancer with one positive lymph node: Equivalent outcomes in patients treated with surgery and radiation therapy versus surgery alone'. Together they form a unique fingerprint.

Cite this