Abstract
Purpose We sought to identify risk factors for distant metastasis (DM) in patients with oropharyngeal cancer (OPC) and perform a recursive partition analysis (RPA) to identify patients both at low and high risk for DM. Methods Our center treated 647 consecutive OPC patients with IMRT between 9/98 and 1/12. The following clinical features were used as prognostic factors: T Stage, N Stage, smoking history, tumor grade, tumor sub-site, the presence of a low lying (level IV or VB) lymph node (LLLN). A Cox model of the risk of DM was used to identify independent prognostic factors. RPA was used to identify patients at low, intermediate, and high risk for DM. Results The median follow-up time in living patients was 42.2 months (range: 2-166). The primary OPC site was the tonsil in 296 patients, base of tongue in 315 patients, and soft palate or pharyngeal wall in 36 patients. For the entire cohort, the Kaplan-Meier estimate for 3 year freedom from distant metastasis was 88.4%. A Cox model identified T Stage (p < 0.001), N Stage (p = 0.02), and LLLN (p = 0.002) as independent predictors of DM. RPA identified patients at low, intermediate, and high risk of DM, with a 3-year freedom-from DM of 98%, 91.1%, and 65.4% respectively. Conclusion The presence of a low lying lymph node is significantly associated with an increased risk of DM in OPC. RPA identified patients both at very low and very high risk for DM with information routinely obtained in clinic.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 863-868 |
| Number of pages | 6 |
| Journal | Oral Oncology |
| Volume | 50 |
| Issue number | 9 |
| DOIs | |
| State | Published - Jan 1 2014 |
| Externally published | Yes |
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Keywords
- Distant metastasis
- Low lying lymph node
- Lymph node staging
- Oropharyngeal cancer
- Recursive partition analysis
ASJC Scopus subject areas
- Oral Surgery
- Oncology
- Cancer Research
Cite this
Patients with low lying lymph nodes are at high risk for distant metastasis in oropharyngeal cancer. / Riaz, Nadeem; Setton, Jeremy; Tam, Moses; Sherman, Eric; Ho, Felix; Katsoulakis, Evangelia; Wong, Richard; Wolden, Suzanne; Rao, Shyam; Lee, Nancy.
In: Oral Oncology, Vol. 50, No. 9, 01.01.2014, p. 863-868.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Patients with low lying lymph nodes are at high risk for distant metastasis in oropharyngeal cancer
AU - Riaz, Nadeem
AU - Setton, Jeremy
AU - Tam, Moses
AU - Sherman, Eric
AU - Ho, Felix
AU - Katsoulakis, Evangelia
AU - Wong, Richard
AU - Wolden, Suzanne
AU - Rao, Shyam
AU - Lee, Nancy
PY - 2014/1/1
Y1 - 2014/1/1
N2 - Purpose We sought to identify risk factors for distant metastasis (DM) in patients with oropharyngeal cancer (OPC) and perform a recursive partition analysis (RPA) to identify patients both at low and high risk for DM. Methods Our center treated 647 consecutive OPC patients with IMRT between 9/98 and 1/12. The following clinical features were used as prognostic factors: T Stage, N Stage, smoking history, tumor grade, tumor sub-site, the presence of a low lying (level IV or VB) lymph node (LLLN). A Cox model of the risk of DM was used to identify independent prognostic factors. RPA was used to identify patients at low, intermediate, and high risk for DM. Results The median follow-up time in living patients was 42.2 months (range: 2-166). The primary OPC site was the tonsil in 296 patients, base of tongue in 315 patients, and soft palate or pharyngeal wall in 36 patients. For the entire cohort, the Kaplan-Meier estimate for 3 year freedom from distant metastasis was 88.4%. A Cox model identified T Stage (p < 0.001), N Stage (p = 0.02), and LLLN (p = 0.002) as independent predictors of DM. RPA identified patients at low, intermediate, and high risk of DM, with a 3-year freedom-from DM of 98%, 91.1%, and 65.4% respectively. Conclusion The presence of a low lying lymph node is significantly associated with an increased risk of DM in OPC. RPA identified patients both at very low and very high risk for DM with information routinely obtained in clinic.
AB - Purpose We sought to identify risk factors for distant metastasis (DM) in patients with oropharyngeal cancer (OPC) and perform a recursive partition analysis (RPA) to identify patients both at low and high risk for DM. Methods Our center treated 647 consecutive OPC patients with IMRT between 9/98 and 1/12. The following clinical features were used as prognostic factors: T Stage, N Stage, smoking history, tumor grade, tumor sub-site, the presence of a low lying (level IV or VB) lymph node (LLLN). A Cox model of the risk of DM was used to identify independent prognostic factors. RPA was used to identify patients at low, intermediate, and high risk for DM. Results The median follow-up time in living patients was 42.2 months (range: 2-166). The primary OPC site was the tonsil in 296 patients, base of tongue in 315 patients, and soft palate or pharyngeal wall in 36 patients. For the entire cohort, the Kaplan-Meier estimate for 3 year freedom from distant metastasis was 88.4%. A Cox model identified T Stage (p < 0.001), N Stage (p = 0.02), and LLLN (p = 0.002) as independent predictors of DM. RPA identified patients at low, intermediate, and high risk of DM, with a 3-year freedom-from DM of 98%, 91.1%, and 65.4% respectively. Conclusion The presence of a low lying lymph node is significantly associated with an increased risk of DM in OPC. RPA identified patients both at very low and very high risk for DM with information routinely obtained in clinic.
KW - Distant metastasis
KW - Low lying lymph node
KW - Lymph node staging
KW - Oropharyngeal cancer
KW - Recursive partition analysis
UR - http://www.scopus.com/inward/record.url?scp=84905924888&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84905924888&partnerID=8YFLogxK
U2 - 10.1016/j.oraloncology.2014.06.008
DO - 10.1016/j.oraloncology.2014.06.008
M3 - Article
C2 - 25043881
AN - SCOPUS:84905924888
VL - 50
SP - 863
EP - 868
JO - Oral Oncology
JF - Oral Oncology
SN - 1368-8375
IS - 9
ER -