Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026
Recurrences and Survival in Oropharyngeal Squamous Cell Carcinoma According to p16 Status and Extranodal Extension.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Boscolo-Rizzo Paolo, Giudici Fabiola, Polesel Jerry, Tagliabue Marta, Sia Egidio, Rampinelli Vittorio, Stellin Marco, Emanuelli Enzo, Vaira Luigi A, Zucchini Simone, Golusinski Pawel, Dequanter Didier, Chiesa-Estomba Carlos, Maniaci Antonino, Lentini Mario, De Berardinis Rita, Szewczyk Mateusz, Lechien Jerome R, Piazza Cesare, Nicolai Piero, Ansarin Mohssen, Tirelli Giancarlo
Аннотация
OBJECTIVE: Extranodal extension (ENE) is a recognized adverse prognostic factor in oropharyngeal squamous cell carcinoma (OPSCC). However, most evidence concerns clinical ENE, whereas data on pathologic ENE (pENE) are limited. With the renewed role of surgery in the management of OPSCC, this study evaluates the prognostic significance of pENE according to HPV status.
STUDY DESIGN: Multicenter retrospective cohort conducted from 2010 to 2021.
SETTING: Specialized otolaryngology-head and neck surgery European departments.
METHODS: Patients aged 18 years or older who underwent primary surgery for OPSCC of the tonsil or base of tongue were included. HPV status was based on p16 expression assessed by immunohistochemistry. pENE was classified as present or absent. We estimated overall survival (OS), disease-free survival (DFS), and recurrence patterns, adjusting for competing risks.
RESULTS: Among 650 patients, 284 (43.7%) were p16-positive and 166 (25.5%) reported presence of pENE. In p16-negative patients, those with pENE showed a worse 5-year DFS (35.6% vs 43.5%; adjusted HR [aHR], 1.64; 95% CI, 1.09-2.46) and OS (43.3% vs 52.0%; aHR, 1.76, 95% CI, 1.14-2.73) than those without. Cumulative incidence of recurrence was significantly higher in p16-negative patients with pENE (55.8% vs 37.0%). pENE was significantly associated with increased risk of distant metastases only in p16-negative patients (21.0% vs 7.6%; aHR, 2.52; 95% CI, 1.03-625).
CONCLUSIONS: The prognostic role of pENE in OPSCC appears to differ by HPV status. These findings underline the importance of considering HPV status when interpreting the prognostic significance of pENE.
STUDY DESIGN: Multicenter retrospective cohort conducted from 2010 to 2021.
SETTING: Specialized otolaryngology-head and neck surgery European departments.
METHODS: Patients aged 18 years or older who underwent primary surgery for OPSCC of the tonsil or base of tongue were included. HPV status was based on p16 expression assessed by immunohistochemistry. pENE was classified as present or absent. We estimated overall survival (OS), disease-free survival (DFS), and recurrence patterns, adjusting for competing risks.
RESULTS: Among 650 patients, 284 (43.7%) were p16-positive and 166 (25.5%) reported presence of pENE. In p16-negative patients, those with pENE showed a worse 5-year DFS (35.6% vs 43.5%; adjusted HR [aHR], 1.64; 95% CI, 1.09-2.46) and OS (43.3% vs 52.0%; aHR, 1.76, 95% CI, 1.14-2.73) than those without. Cumulative incidence of recurrence was significantly higher in p16-negative patients with pENE (55.8% vs 37.0%). pENE was significantly associated with increased risk of distant metastases only in p16-negative patients (21.0% vs 7.6%; aHR, 2.52; 95% CI, 1.03-625).
CONCLUSIONS: The prognostic role of pENE in OPSCC appears to differ by HPV status. These findings underline the importance of considering HPV status when interpreting the prognostic significance of pENE.