Prognostic Value of Radiologic Extranodal Extension in Human Papillomavirus-Related Oropharyngeal Squamous Cell Carcinoma
- Author:
Boeun LEE
1
;
Young Jun CHOI
;
Seon Ok KIM
;
Yoon Se LEE
;
Jung Yong HONG
;
Jung Hwan BAEK
;
Jeong Hyun LEE
Author Information
- Publication Type:Original Article
- Keywords: Human papillomavirus; Oropharyngeal squamous cell carcinoma; Extranodal extension; Prognosis
- MeSH: Carcinoma, Squamous Cell; Cohort Studies; Diagnosis; Disease-Free Survival; Epithelial Cells; Head; Humans; Lymph Nodes; Magnetic Resonance Imaging; Multivariate Analysis; Neck; Neck Dissection; Prognosis; Sensitivity and Specificity
- From:Korean Journal of Radiology 2019;20(8):1266-1274
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: To determine whether radiologic extranodal extension (ENE) appearing on pretreatment CT and MRI could predict the prognosis in patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC). MATERIALS AND METHODS: The study population was obtained from a historical cohort diagnosed with HPV-related OPSCC. A total of 134 OPSCC patients who had a metastatic lymph node on pretreatment CT or MRI were included, and radiologic ENE was evaluated by two experienced head and neck radiologists. Kaplan-Meier and multivariate Cox regression analyses were performed to evaluate the impact of radiologic ENE on progression-free survival (PFS). The diagnostic performance of CT and MRI for the diagnosis of ENE was also evaluated in patients who underwent neck dissection. RESULTS: Seventy patients (52.2%) showed radiologic ENE-positive findings. Although patients showing radiologic ENE had a worse 3-year PFS (83.7% vs. 95.3%, p = 0.023), the association between radiologic ENE and PFS was not statistically significant on multivariate analysis (p = 0.141; hazard ratio, 2.68; 95% confidence interval, 0.72–9.97). CT or MRI had a sensitivity of 62%, specificity of 77.8%, and accuracy of 71.9% for predicting pathologic ENE. CONCLUSION: Radiologic ENE on CT or MRI did not predict poor PFS in patients with HPV-related OPSCC, although there was a trend towards worse PFS. Further studies are warranted to determine whether radiologic ENE is a useful imaging biomarker to risk-stratify patients with HPV-related OPSCC.
