Cystic nodal metastasis in patients with oropharyngeal squamous cell carcinoma receiving chemoradiotherapy

Relationship with human papillomavirus status and failure patterns

Yu Han Huang, Chih Hua Yeh, Nai Ming Cheng, Chien Yu Lin, Hung Ming Wang, Sheung Fat Ko, Cheng Hong Toh, Tzu Chen Yen, Chun Ta Liao, Shu Hang Ng

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objectives: We investigated the relationships of cystic nodal metastasis, human papillomavirus (HPV) status, and treatment failure patterns in patients with oropharyngeal squamous cell carcinoma (OPSCC) treated with chemoradiotherapy. Methods: We retrospectively reviewed pretreatment MRI and clinical courses of patients with OPSCC whose tumors were tested for HPV-induced p16 expression via immunohistochemistry and who completed chemoradiotherapy. Cervical cystic nodal metastasis and necrotic nodal metastasis were classified on MRI. Results: Of 98 patients eligible for analysis, 33 were p16-positive. Cystic nodal metastasis was significantly more prevalent in p16-positive than in p16-negative patients (39.4% versus 18.5%, respectively; p = 0.025). Necrotic nodal metastasis was significantly more prevalent in p16-negative than in p16-positive patients (73.8% versus 51.5%, respectively; p = 0.027). On multivariate analysis, necrotic nodal metastasis (odds ratio [OR] = 7.310, p = 0.011) was an independent predictor of regional failure, while advanced nodal stage (OR = 4.119, p = 0.022) and cystic nodal metastases (OR = 0.087, p = 0.026) were independent positive and negative predictors of distant failure, respectively. Conclusions: Cervical cystic and necrotic nodal metastases are associated with HPV-induced p16-positive and p16-negative OPSCC, respectively. Patients with necrotic nodal metastasis at presentation have an increased risk of regional failure. Distant failure is directly and inversely correlated with advanced nodal stage and cystic nodal metastasis, respectively.

Original languageEnglish
Article numbere0180779
JournalPLoS One
Volume12
Issue number7
DOIs
Publication statusPublished - Jul 1 2017

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Chemoradiotherapy
Papillomaviridae
squamous cell carcinoma
metastasis
Squamous Cell Carcinoma
Neoplasm Metastasis
Magnetic resonance imaging
Tumors
odds ratio
Odds Ratio
Epithelial Cells
Treatment Failure
disease course
multivariate analysis
immunohistochemistry

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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Cystic nodal metastasis in patients with oropharyngeal squamous cell carcinoma receiving chemoradiotherapy : Relationship with human papillomavirus status and failure patterns. / Huang, Yu Han; Yeh, Chih Hua; Cheng, Nai Ming; Lin, Chien Yu; Wang, Hung Ming; Ko, Sheung Fat; Toh, Cheng Hong; Yen, Tzu Chen; Liao, Chun Ta; Ng, Shu Hang.

In: PLoS One, Vol. 12, No. 7, e0180779, 01.07.2017.

Research output: Contribution to journalArticle

Huang, Yu Han ; Yeh, Chih Hua ; Cheng, Nai Ming ; Lin, Chien Yu ; Wang, Hung Ming ; Ko, Sheung Fat ; Toh, Cheng Hong ; Yen, Tzu Chen ; Liao, Chun Ta ; Ng, Shu Hang. / Cystic nodal metastasis in patients with oropharyngeal squamous cell carcinoma receiving chemoradiotherapy : Relationship with human papillomavirus status and failure patterns. In: PLoS One. 2017 ; Vol. 12, No. 7.
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abstract = "Objectives: We investigated the relationships of cystic nodal metastasis, human papillomavirus (HPV) status, and treatment failure patterns in patients with oropharyngeal squamous cell carcinoma (OPSCC) treated with chemoradiotherapy. Methods: We retrospectively reviewed pretreatment MRI and clinical courses of patients with OPSCC whose tumors were tested for HPV-induced p16 expression via immunohistochemistry and who completed chemoradiotherapy. Cervical cystic nodal metastasis and necrotic nodal metastasis were classified on MRI. Results: Of 98 patients eligible for analysis, 33 were p16-positive. Cystic nodal metastasis was significantly more prevalent in p16-positive than in p16-negative patients (39.4{\%} versus 18.5{\%}, respectively; p = 0.025). Necrotic nodal metastasis was significantly more prevalent in p16-negative than in p16-positive patients (73.8{\%} versus 51.5{\%}, respectively; p = 0.027). On multivariate analysis, necrotic nodal metastasis (odds ratio [OR] = 7.310, p = 0.011) was an independent predictor of regional failure, while advanced nodal stage (OR = 4.119, p = 0.022) and cystic nodal metastases (OR = 0.087, p = 0.026) were independent positive and negative predictors of distant failure, respectively. Conclusions: Cervical cystic and necrotic nodal metastases are associated with HPV-induced p16-positive and p16-negative OPSCC, respectively. Patients with necrotic nodal metastasis at presentation have an increased risk of regional failure. Distant failure is directly and inversely correlated with advanced nodal stage and cystic nodal metastasis, respectively.",
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T2 - Relationship with human papillomavirus status and failure patterns

AU - Huang, Yu Han

AU - Yeh, Chih Hua

AU - Cheng, Nai Ming

AU - Lin, Chien Yu

AU - Wang, Hung Ming

AU - Ko, Sheung Fat

AU - Toh, Cheng Hong

AU - Yen, Tzu Chen

AU - Liao, Chun Ta

AU - Ng, Shu Hang

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N2 - Objectives: We investigated the relationships of cystic nodal metastasis, human papillomavirus (HPV) status, and treatment failure patterns in patients with oropharyngeal squamous cell carcinoma (OPSCC) treated with chemoradiotherapy. Methods: We retrospectively reviewed pretreatment MRI and clinical courses of patients with OPSCC whose tumors were tested for HPV-induced p16 expression via immunohistochemistry and who completed chemoradiotherapy. Cervical cystic nodal metastasis and necrotic nodal metastasis were classified on MRI. Results: Of 98 patients eligible for analysis, 33 were p16-positive. Cystic nodal metastasis was significantly more prevalent in p16-positive than in p16-negative patients (39.4% versus 18.5%, respectively; p = 0.025). Necrotic nodal metastasis was significantly more prevalent in p16-negative than in p16-positive patients (73.8% versus 51.5%, respectively; p = 0.027). On multivariate analysis, necrotic nodal metastasis (odds ratio [OR] = 7.310, p = 0.011) was an independent predictor of regional failure, while advanced nodal stage (OR = 4.119, p = 0.022) and cystic nodal metastases (OR = 0.087, p = 0.026) were independent positive and negative predictors of distant failure, respectively. Conclusions: Cervical cystic and necrotic nodal metastases are associated with HPV-induced p16-positive and p16-negative OPSCC, respectively. Patients with necrotic nodal metastasis at presentation have an increased risk of regional failure. Distant failure is directly and inversely correlated with advanced nodal stage and cystic nodal metastasis, respectively.

AB - Objectives: We investigated the relationships of cystic nodal metastasis, human papillomavirus (HPV) status, and treatment failure patterns in patients with oropharyngeal squamous cell carcinoma (OPSCC) treated with chemoradiotherapy. Methods: We retrospectively reviewed pretreatment MRI and clinical courses of patients with OPSCC whose tumors were tested for HPV-induced p16 expression via immunohistochemistry and who completed chemoradiotherapy. Cervical cystic nodal metastasis and necrotic nodal metastasis were classified on MRI. Results: Of 98 patients eligible for analysis, 33 were p16-positive. Cystic nodal metastasis was significantly more prevalent in p16-positive than in p16-negative patients (39.4% versus 18.5%, respectively; p = 0.025). Necrotic nodal metastasis was significantly more prevalent in p16-negative than in p16-positive patients (73.8% versus 51.5%, respectively; p = 0.027). On multivariate analysis, necrotic nodal metastasis (odds ratio [OR] = 7.310, p = 0.011) was an independent predictor of regional failure, while advanced nodal stage (OR = 4.119, p = 0.022) and cystic nodal metastases (OR = 0.087, p = 0.026) were independent positive and negative predictors of distant failure, respectively. Conclusions: Cervical cystic and necrotic nodal metastases are associated with HPV-induced p16-positive and p16-negative OPSCC, respectively. Patients with necrotic nodal metastasis at presentation have an increased risk of regional failure. Distant failure is directly and inversely correlated with advanced nodal stage and cystic nodal metastasis, respectively.

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