Extracapsular spread in head and neck carcinoma

Impact of site and human papillomavirus status

Jessica H. Maxwell, Robert L. Ferris, William Gooding, Diana Cunningham, Vikas Mehta, Seungwon Kim, Eugene N. Myers, Jonas Johnson, Simion Chiosea

Research output: Contribution to journalArticle

99 Citations (Scopus)

Abstract

Background: Extracapsular spread (ECS) in cervical lymph node metastases from head and neck squamous cell carcinoma (SCC) is regarded as an adverse prognostic factor and is often used to select patients who may benefit from adjuvant therapy. The prognostic value of ECS was evaluated for patients with oropharyngeal SCC (OPC; with known p16/human papillomavirus [HPV] status) and for patients with SCC of the oral cavity (OCC). Methods: Disease-specific survival (DSS) was assessed among SCC patients with cervical lymph node metastases (n = 347, including 133 patients with OPC and 214 patients with OCC). All patients were treated surgically between 1983 and 2009. ECS status was determined by pathologists at the time of initial pathologic evaluation and confirmed for this study. HPV status of patients with OPC was determined via immunohistochemistry for p16 and in situ hybridization. Results: Among OCC patients, ECS was a significant, independent factor influencing DSS. For OCC patients with ECS, 3-year DSS was 45% (95% confidence interval [CI], 36%-56%); for those without ECS, 3-year DSS was 71% (95% CI, 62%-81%; P =.0018). The effect of ECS was independent of the number of positive lymph nodes as well as other clinical, pathologic, and treatment variables. Of the 133 OPC patients, 76 (57%) were p16-positive and 57 (43%) were p16-negative. ECS status did not correlate with DSS among p16-positive or p16-negative OPC patients. CONCLUSION ECS was not associated with worse DSS in p16-positive or p16-negative OPC patients. Adverse prognostic value of ECS in OCC patients was confirmed.

Original languageEnglish (US)
Pages (from-to)3302-3308
Number of pages7
JournalCancer
Volume119
Issue number18
DOIs
StatePublished - Sep 15 2013
Externally publishedYes

Fingerprint

Neck
Head
Carcinoma
Survival
Squamous Cell Carcinoma
Lymph Nodes
Confidence Intervals
Neoplasm Metastasis
In Situ Hybridization
Mouth
Immunohistochemistry

Keywords

  • Extracapsular spread
  • HPV
  • oral cavity
  • p16, oropharynx
  • squamous cell carcinoma

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Maxwell, J. H., Ferris, R. L., Gooding, W., Cunningham, D., Mehta, V., Kim, S., ... Chiosea, S. (2013). Extracapsular spread in head and neck carcinoma: Impact of site and human papillomavirus status. Cancer, 119(18), 3302-3308. https://doi.org/10.1002/cncr.28169

Extracapsular spread in head and neck carcinoma : Impact of site and human papillomavirus status. / Maxwell, Jessica H.; Ferris, Robert L.; Gooding, William; Cunningham, Diana; Mehta, Vikas; Kim, Seungwon; Myers, Eugene N.; Johnson, Jonas; Chiosea, Simion.

In: Cancer, Vol. 119, No. 18, 15.09.2013, p. 3302-3308.

Research output: Contribution to journalArticle

Maxwell, JH, Ferris, RL, Gooding, W, Cunningham, D, Mehta, V, Kim, S, Myers, EN, Johnson, J & Chiosea, S 2013, 'Extracapsular spread in head and neck carcinoma: Impact of site and human papillomavirus status', Cancer, vol. 119, no. 18, pp. 3302-3308. https://doi.org/10.1002/cncr.28169
Maxwell JH, Ferris RL, Gooding W, Cunningham D, Mehta V, Kim S et al. Extracapsular spread in head and neck carcinoma: Impact of site and human papillomavirus status. Cancer. 2013 Sep 15;119(18):3302-3308. https://doi.org/10.1002/cncr.28169
Maxwell, Jessica H. ; Ferris, Robert L. ; Gooding, William ; Cunningham, Diana ; Mehta, Vikas ; Kim, Seungwon ; Myers, Eugene N. ; Johnson, Jonas ; Chiosea, Simion. / Extracapsular spread in head and neck carcinoma : Impact of site and human papillomavirus status. In: Cancer. 2013 ; Vol. 119, No. 18. pp. 3302-3308.
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abstract = "Background: Extracapsular spread (ECS) in cervical lymph node metastases from head and neck squamous cell carcinoma (SCC) is regarded as an adverse prognostic factor and is often used to select patients who may benefit from adjuvant therapy. The prognostic value of ECS was evaluated for patients with oropharyngeal SCC (OPC; with known p16/human papillomavirus [HPV] status) and for patients with SCC of the oral cavity (OCC). Methods: Disease-specific survival (DSS) was assessed among SCC patients with cervical lymph node metastases (n = 347, including 133 patients with OPC and 214 patients with OCC). All patients were treated surgically between 1983 and 2009. ECS status was determined by pathologists at the time of initial pathologic evaluation and confirmed for this study. HPV status of patients with OPC was determined via immunohistochemistry for p16 and in situ hybridization. Results: Among OCC patients, ECS was a significant, independent factor influencing DSS. For OCC patients with ECS, 3-year DSS was 45{\%} (95{\%} confidence interval [CI], 36{\%}-56{\%}); for those without ECS, 3-year DSS was 71{\%} (95{\%} CI, 62{\%}-81{\%}; P =.0018). The effect of ECS was independent of the number of positive lymph nodes as well as other clinical, pathologic, and treatment variables. Of the 133 OPC patients, 76 (57{\%}) were p16-positive and 57 (43{\%}) were p16-negative. ECS status did not correlate with DSS among p16-positive or p16-negative OPC patients. CONCLUSION ECS was not associated with worse DSS in p16-positive or p16-negative OPC patients. Adverse prognostic value of ECS in OCC patients was confirmed.",
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T1 - Extracapsular spread in head and neck carcinoma

T2 - Impact of site and human papillomavirus status

AU - Maxwell, Jessica H.

AU - Ferris, Robert L.

AU - Gooding, William

AU - Cunningham, Diana

AU - Mehta, Vikas

AU - Kim, Seungwon

AU - Myers, Eugene N.

AU - Johnson, Jonas

AU - Chiosea, Simion

PY - 2013/9/15

Y1 - 2013/9/15

N2 - Background: Extracapsular spread (ECS) in cervical lymph node metastases from head and neck squamous cell carcinoma (SCC) is regarded as an adverse prognostic factor and is often used to select patients who may benefit from adjuvant therapy. The prognostic value of ECS was evaluated for patients with oropharyngeal SCC (OPC; with known p16/human papillomavirus [HPV] status) and for patients with SCC of the oral cavity (OCC). Methods: Disease-specific survival (DSS) was assessed among SCC patients with cervical lymph node metastases (n = 347, including 133 patients with OPC and 214 patients with OCC). All patients were treated surgically between 1983 and 2009. ECS status was determined by pathologists at the time of initial pathologic evaluation and confirmed for this study. HPV status of patients with OPC was determined via immunohistochemistry for p16 and in situ hybridization. Results: Among OCC patients, ECS was a significant, independent factor influencing DSS. For OCC patients with ECS, 3-year DSS was 45% (95% confidence interval [CI], 36%-56%); for those without ECS, 3-year DSS was 71% (95% CI, 62%-81%; P =.0018). The effect of ECS was independent of the number of positive lymph nodes as well as other clinical, pathologic, and treatment variables. Of the 133 OPC patients, 76 (57%) were p16-positive and 57 (43%) were p16-negative. ECS status did not correlate with DSS among p16-positive or p16-negative OPC patients. CONCLUSION ECS was not associated with worse DSS in p16-positive or p16-negative OPC patients. Adverse prognostic value of ECS in OCC patients was confirmed.

AB - Background: Extracapsular spread (ECS) in cervical lymph node metastases from head and neck squamous cell carcinoma (SCC) is regarded as an adverse prognostic factor and is often used to select patients who may benefit from adjuvant therapy. The prognostic value of ECS was evaluated for patients with oropharyngeal SCC (OPC; with known p16/human papillomavirus [HPV] status) and for patients with SCC of the oral cavity (OCC). Methods: Disease-specific survival (DSS) was assessed among SCC patients with cervical lymph node metastases (n = 347, including 133 patients with OPC and 214 patients with OCC). All patients were treated surgically between 1983 and 2009. ECS status was determined by pathologists at the time of initial pathologic evaluation and confirmed for this study. HPV status of patients with OPC was determined via immunohistochemistry for p16 and in situ hybridization. Results: Among OCC patients, ECS was a significant, independent factor influencing DSS. For OCC patients with ECS, 3-year DSS was 45% (95% confidence interval [CI], 36%-56%); for those without ECS, 3-year DSS was 71% (95% CI, 62%-81%; P =.0018). The effect of ECS was independent of the number of positive lymph nodes as well as other clinical, pathologic, and treatment variables. Of the 133 OPC patients, 76 (57%) were p16-positive and 57 (43%) were p16-negative. ECS status did not correlate with DSS among p16-positive or p16-negative OPC patients. CONCLUSION ECS was not associated with worse DSS in p16-positive or p16-negative OPC patients. Adverse prognostic value of ECS in OCC patients was confirmed.

KW - Extracapsular spread

KW - HPV

KW - oral cavity

KW - p16, oropharynx

KW - squamous cell carcinoma

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