TY - JOUR
T1 - Clinical nodal staging of T1-2 tonsillar squamous cell carcinoma stratified by p16 status and implications for ipsilateral neck irradiation
AU - Shoushtari, Asal N.
AU - Meeneghan, Mathew
AU - Treharne, Gregory C.
AU - Reibel, James F.
AU - Levine, Paul A.
AU - Moskaluk, Christopher A.
AU - Jameson, Mark J.
AU - Read, Paul W.
PY - 2010/5
Y1 - 2010/5
N2 - Background and Purpose: Previous studies have reported <5% incidence of contralateral nodal metastasis in patients with T1-2 tonsillar squamous cell carcinoma. We analyzed the nodal staging of T1-2 tonsillar squamous cell carcinoma stratified for p16 status, a marker of human papillomavirus positivity. Materials and Methods: Clinical and radiographic nodal staging and p16 status of 41 T1-2 tonsillar squamous cell carcinoma patients who were treated between January 2002 and June 2009 were retrospectively analyzed. Patients with a history of prior head and neck cancer, synchronous cancers, base of tongue or soft palate invasion, or distant metastases at diagnosis were excluded. Results: Of the 41 patients, 28 (68.2%) had p16+ tumors and 13 (31.7%) had p16- tumors. Seven patients (17.0%) presented with contralateral cervical nodal disease, all of whom had p16+ tumors. Furthermore, 25.0% of patients with p16+ tumors presented with contralateral cervical nodal disease compared with 0% of patients with p16- tumors. Conclusions: Patients with p16+ T1-2 tonsillar squamous cell carcinoma present with a higher incidence of contralateral nodal spread than those patients with p16- disease. This may have clinical implications when determining which patients are good candidates for ipsilateral cervical nodal irradiation.
AB - Background and Purpose: Previous studies have reported <5% incidence of contralateral nodal metastasis in patients with T1-2 tonsillar squamous cell carcinoma. We analyzed the nodal staging of T1-2 tonsillar squamous cell carcinoma stratified for p16 status, a marker of human papillomavirus positivity. Materials and Methods: Clinical and radiographic nodal staging and p16 status of 41 T1-2 tonsillar squamous cell carcinoma patients who were treated between January 2002 and June 2009 were retrospectively analyzed. Patients with a history of prior head and neck cancer, synchronous cancers, base of tongue or soft palate invasion, or distant metastases at diagnosis were excluded. Results: Of the 41 patients, 28 (68.2%) had p16+ tumors and 13 (31.7%) had p16- tumors. Seven patients (17.0%) presented with contralateral cervical nodal disease, all of whom had p16+ tumors. Furthermore, 25.0% of patients with p16+ tumors presented with contralateral cervical nodal disease compared with 0% of patients with p16- tumors. Conclusions: Patients with p16+ T1-2 tonsillar squamous cell carcinoma present with a higher incidence of contralateral nodal spread than those patients with p16- disease. This may have clinical implications when determining which patients are good candidates for ipsilateral cervical nodal irradiation.
KW - Human papillomavirus
KW - Ipsilateral cervical radiation for tonsillar cancer
KW - Oropharyngeal squamous cell carcinoma
KW - P16
KW - T1 and T2 tonsillar cancer
UR - http://www.scopus.com/inward/record.url?scp=77953646508&partnerID=8YFLogxK
U2 - 10.1097/PPO.0b013e3181ddd088
DO - 10.1097/PPO.0b013e3181ddd088
M3 - Article
C2 - 20526108
AN - SCOPUS:77953646508
SN - 1528-9117
VL - 16
SP - 284
EP - 287
JO - Cancer Journal
JF - Cancer Journal
IS - 3
ER -