- Radiologic extranodal extension (rENE) is associated with poor distant control (DC) and survival in patients with cN+ TNM8 stage I HPV-positive oropharyngeal cancer (OPC) treated with definitive intensity-modulated radiotherapy (IMRT).
Why this matters
- Identification of radiologic features predicting poor prognosis may help with patient management.
- Patients with rENE had reduced 5-year DC, DFS, and OS compared with patients without rENE (78% vs 95% [P<.001 vs respectively>
- Patients with and without rENE had similar locoregional control (93% vs 97%; P=.34).
- In subgroup analysis, rENE was associated with reduced DC and DFS in patients treated with IMRT alone (N=85; 74% vs 96% [P=.029] and 45% vs 83% [P=.014], respectively) and those treated with IMRT plus systemic agents (N=195; 79% vs 95% [P=.001] and 63% vs 92% [P<.001 respectively>
- rENE (HR, 4.3, P<.001 t2 category vs t1 and smoking pack-years were associated with poor dfs in multivariate analysis whereas addition of systemic agents was improved dfs.>
- 280 patients with HPV-positive cT1-T2cN1 OPC treated with definitive IMRT, 45 with rENE, were analyzed for outcomes.
- Funding: None
- Retrospective study.