Retropharyngeal Lymph Node Involvement in Oropharyngeal Carcinoma: Impact upon Risk of Distant Metastases and Survival Outcomes

The influence of retropharyngeal lymph node (RPLN) involvement on prognosis in oropharyngeal carcinoma remains poorly defined. The aim of this study was to assess the impact of RPLN involvement upon outcomes. A single-centre retrospective analysis of 402 patients with oropharyngeal carcinoma treated...

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Main Authors: Zsuzsanna Iyizoba-Ebozue, Louise J. Murray, Moses Arunsingh, Karen E. Dyker, Sriram Vaidyanathan, Andrew F. Scarsbrook, Robin J. D. Prestwich
Format: Article
Language:English
Published: MDPI AG 2019-12-01
Series:Cancers
Subjects:
Online Access:https://www.mdpi.com/2072-6694/12/1/83
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author Zsuzsanna Iyizoba-Ebozue
Louise J. Murray
Moses Arunsingh
Karen E. Dyker
Sriram Vaidyanathan
Andrew F. Scarsbrook
Robin J. D. Prestwich
author_facet Zsuzsanna Iyizoba-Ebozue
Louise J. Murray
Moses Arunsingh
Karen E. Dyker
Sriram Vaidyanathan
Andrew F. Scarsbrook
Robin J. D. Prestwich
author_sort Zsuzsanna Iyizoba-Ebozue
collection DOAJ
description The influence of retropharyngeal lymph node (RPLN) involvement on prognosis in oropharyngeal carcinoma remains poorly defined. The aim of this study was to assess the impact of RPLN involvement upon outcomes. A single-centre retrospective analysis of 402 patients with oropharyngeal carcinoma treated nonsurgically between 2010 and 2017 was performed. All had a baseline 2-[fluorine-18]-fluoro-2-deoxy-<span style="font-variant: small-caps;">d</span>-glucose (FDG) PET-CT and contrast-enhanced MRI and/or CT. RPLN status was determined by radiology review of cases with reported abnormal RPLN. Multivariate backwards logistic regression was used to examine impact on outcomes of factors. Abnormal RPLNs were identified in 40/402 (10%) of patients. Median follow up was 42.9 months. RPLN involvement was associated with inferior 3 year outcomes for overall survival (OS) (67.1% vs. 79.1%, <i>p</i> = 0.006) and distant metastases-free survival (DMFS) (73.9% versus 88.0%, <i>p</i> = 0.011), with no significant difference in local control (81.6% vs. 87.7%, <i>p</i> = 0.154) or regional control (80.7% vs. 85.4%, <i>p</i> = 0.252). On multivariate analysis abnormal RPLN, no concurrent chemotherapy and ongoing smoking were associated with inferior DMFS and OS, while advanced T stage was also associated with inferior OS. In summary, RPLN involvement, present in 10% of patients, was an independent prognostic factor for the development of distant disease failure translating into inferior OS. These findings need confirmation in future studies.
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spelling doaj.art-23de5f94d71248c480acbbc1124ee0c42023-09-03T05:30:23ZengMDPI AGCancers2072-66942019-12-011218310.3390/cancers12010083cancers12010083Retropharyngeal Lymph Node Involvement in Oropharyngeal Carcinoma: Impact upon Risk of Distant Metastases and Survival OutcomesZsuzsanna Iyizoba-Ebozue0Louise J. Murray1Moses Arunsingh2Karen E. Dyker3Sriram Vaidyanathan4Andrew F. Scarsbrook5Robin J. D. Prestwich6Department of Clinical Oncology, Leeds Cancer Centre, Leeds LS97TF, UKDepartment of Clinical Oncology, Leeds Cancer Centre, Leeds LS97TF, UKDepartment of Clinical Oncology, Leeds Cancer Centre, Leeds LS97TF, UKDepartment of Clinical Oncology, Leeds Cancer Centre, Leeds LS97TF, UKDepartment of Nuclear Medicine and Radiology, Leeds Cancer Centre, Leeds LS97TF, UKLeeds Institute of Medical Research at St James’s, University of Leeds, Leeds LS97TF, UKDepartment of Clinical Oncology, Leeds Cancer Centre, Leeds LS97TF, UKThe influence of retropharyngeal lymph node (RPLN) involvement on prognosis in oropharyngeal carcinoma remains poorly defined. The aim of this study was to assess the impact of RPLN involvement upon outcomes. A single-centre retrospective analysis of 402 patients with oropharyngeal carcinoma treated nonsurgically between 2010 and 2017 was performed. All had a baseline 2-[fluorine-18]-fluoro-2-deoxy-<span style="font-variant: small-caps;">d</span>-glucose (FDG) PET-CT and contrast-enhanced MRI and/or CT. RPLN status was determined by radiology review of cases with reported abnormal RPLN. Multivariate backwards logistic regression was used to examine impact on outcomes of factors. Abnormal RPLNs were identified in 40/402 (10%) of patients. Median follow up was 42.9 months. RPLN involvement was associated with inferior 3 year outcomes for overall survival (OS) (67.1% vs. 79.1%, <i>p</i> = 0.006) and distant metastases-free survival (DMFS) (73.9% versus 88.0%, <i>p</i> = 0.011), with no significant difference in local control (81.6% vs. 87.7%, <i>p</i> = 0.154) or regional control (80.7% vs. 85.4%, <i>p</i> = 0.252). On multivariate analysis abnormal RPLN, no concurrent chemotherapy and ongoing smoking were associated with inferior DMFS and OS, while advanced T stage was also associated with inferior OS. In summary, RPLN involvement, present in 10% of patients, was an independent prognostic factor for the development of distant disease failure translating into inferior OS. These findings need confirmation in future studies.https://www.mdpi.com/2072-6694/12/1/83oropharynx cancerradiotherapychemotherapylymph noderetropharyngealdistant metastasessurvival
spellingShingle Zsuzsanna Iyizoba-Ebozue
Louise J. Murray
Moses Arunsingh
Karen E. Dyker
Sriram Vaidyanathan
Andrew F. Scarsbrook
Robin J. D. Prestwich
Retropharyngeal Lymph Node Involvement in Oropharyngeal Carcinoma: Impact upon Risk of Distant Metastases and Survival Outcomes
Cancers
oropharynx cancer
radiotherapy
chemotherapy
lymph node
retropharyngeal
distant metastases
survival
title Retropharyngeal Lymph Node Involvement in Oropharyngeal Carcinoma: Impact upon Risk of Distant Metastases and Survival Outcomes
title_full Retropharyngeal Lymph Node Involvement in Oropharyngeal Carcinoma: Impact upon Risk of Distant Metastases and Survival Outcomes
title_fullStr Retropharyngeal Lymph Node Involvement in Oropharyngeal Carcinoma: Impact upon Risk of Distant Metastases and Survival Outcomes
title_full_unstemmed Retropharyngeal Lymph Node Involvement in Oropharyngeal Carcinoma: Impact upon Risk of Distant Metastases and Survival Outcomes
title_short Retropharyngeal Lymph Node Involvement in Oropharyngeal Carcinoma: Impact upon Risk of Distant Metastases and Survival Outcomes
title_sort retropharyngeal lymph node involvement in oropharyngeal carcinoma impact upon risk of distant metastases and survival outcomes
topic oropharynx cancer
radiotherapy
chemotherapy
lymph node
retropharyngeal
distant metastases
survival
url https://www.mdpi.com/2072-6694/12/1/83
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