CC BY-NC-ND 4.0 · Laryngorhinootologie 2018; 97(S 02): S114
DOI: 10.1055/s-0038-1640106
Abstracts
Onkologie: Oncology

Salvage neck dissection after primary radiochemotherapy in HPV-positive and HPV-negative oropharyngeal cancer

S Müller
1   Universitätsklinikum Erlangen, Erlangen
,
J Hornung
1   Universitätsklinikum Erlangen, Erlangen
,
H Iro
1   Universitätsklinikum Erlangen, Erlangen
,
C Scherl
1   Universitätsklinikum Erlangen, Erlangen
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    Introduction:

    Human papillomavirus (HPV)-positive and -negative oropharyngeal cancers (OPC) are separate tumor entities. The aim of this study was to examine if the occurrence of malignant nodes varies for HPV-positive and -negative carcinomas after salvage neck dissection (SND), if that leads to different therapeutical options and if a salvage neck dissection is generally justified for OPC after primary radiochemotherapy (pRCT).

    Methods:

    Retrospective study of 175 patients who underwent pRCT for OPC between 2009 and 2016. 46 patients were HPV-positive (26.3%), 87 patients HPV-negative (49.7%) and for 42 patients the HPV-status was unknown (24%). A SND was performed for 13 (28.3%) HPV-positive carcinomas, 16 (18.4%) HPV-negative carcinomas and 5 (11.9%) carcinomas with unknown HPV-status. The clinical nodal status was assessed using ultrasound and in most cases an additional computed tomography of the neck with contrast.

    Results:

    No significant association between the HPV-status and the indication for SND could be found (p = 0.13). Additionally, no significant association between the HPV-status and the occurrence of malignant nodes could be shown (p = 0.45). The probability for the persistence of the ypN+ nodal status independent of the HPV-status was 29.4%.

    Conclusions:

    Although HPV-positive cancer generally shows a higher radiosensibility, a significant association between the HPV-status and the indication for a SND as well as for persistent malignant nodes after pRCT could not be found. Consequently, a positive HPV-status does not justify a de-escalation regarding the SND. The performance of a SND is generally recommended for patients with OPC as the probability for malignancy is 29.4%.


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    No conflict of interest has been declared by the author(s).

    Dr. Sarina Müller
    Universitätsklinikum Erlangen,
    Waldstraße 1, 91054,
    Erlangen

    Publication History

    Publication Date:
    18 April 2018 (online)

    © 2018. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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