Affiliation:
1. Western University of Health Sciences College of Osteopathic Medicine of the Pacific Pomona California USA
2. Department of Radiation Oncology City of Hope National Medical Center Duarte California USA
3. Department of Surgery City of Hope National Medical Center Duarte California USA
4. Department of Medical Oncology and Therapeutics Research City of Hope National Medical Center Duarte California USA
Abstract
AbstractBackgroundThis study characterized whether the updated AJCC 8th edition nodal staging system for p16+ oropharyngeal squamous cell carcinoma (OPSCC) resulted in the loss of prognostic value.MethodsThe NCDB was queried for patients with node‐positive p16+ OPSCC. The prognostic impact of nodal size, nodal quantity, nodal laterality, and extracapsular extension (ECE) on overall survival (OS) was assessed.ResultsIn the clinical cohort, inferior 5‐year OS was observed in patients with more than one positive lymph node (p < 0.001; 82% vs. 86%), ECE (p < 0.001; 82% vs. 75%), or nodal size >6 cm (p < 0.001; 66% vs. 82%). In the pathologic cohort, inferior 5‐year OS was observed in patients with > four positive lymph nodes (p < 0.001; 76% vs. 90%), ECE (p < 0.001; 83% vs. 92%), or largest nodal size >6 cm (p < 0.001; 81% vs. 89%).ConclusionsSimplifications in the current p16+ OPSCC staging system led to loss of prognostic information in nodal staging.