Radiographic muscle invasion not a recurrence predictor in HPV-associated oropharyngeal squamous cell carcinoma

Laryngoscope. 2019 Apr;129(4):871-876. doi: 10.1002/lary.27351. Epub 2018 Oct 16.

Abstract

Objective: To determine whether muscle invasion evident on pretreatment imaging in p16 + oropharyngeal squamous cell carcinoma (OPSCC) correlates with recurrence.

Study design: Retrospective review.

Methods: Two-hundred and seventy-six patients with p16 + OPSCC treated at a tertiary referral center from 2003 to 2015 were analyzed. All scans were reviewed by a dedicated neuroradiologist with subspecialty expertise in head and neck imaging. Radiographic evidence of muscle invasion to the genioglossus, hyoglossus, medial pterygoid, and prevertebral muscles was analyzed. Local and regional recurrence rates were compared between the muscle invasion and no muscle invasion groups.

Results: One hundred and ninety patients met inclusion criteria with adequate follow-up data and pretreatment imaging. Patients were predominantly male (87.5% male) and smokers (65.6% smokers) with a mean age of 56.7 (standard deviation: 9.0 years). Most commonly invaded muscles in the muscle invasion group were hyoglossus (57.8%) and genioglossus (56.3%). There was no statistically significant difference in primary site or nodal recurrence between the combined group, including definite or possible muscle invasion and the group without muscle invasion (P = 0.205 and P = 0.569, respectively). Additionally, no statistically significant difference was present in recurrence-free and disease-specific survival between the two groups at 3- and 5-year follow-up (P > 0.05).

Conclusion: Radiographic evidence of muscle invasion does not appear to be a predictor of human papilloma virus (+) OPSCC recurrence. Additional studies are needed to validate our findings.

Level of evidence: 4 Laryngoscope, 129:871-876, 2019.

Keywords: Oropharyngeal cancer; human papilloma virus; squamous cell carcinoma.

Publication types

  • Evaluation Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Carcinoma, Squamous Cell / diagnostic imaging*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / virology
  • Female
  • Humans
  • Laryngeal Muscles / diagnostic imaging
  • Laryngeal Muscles / pathology
  • Laryngeal Muscles / virology
  • Male
  • Masticatory Muscles / diagnostic imaging
  • Masticatory Muscles / pathology
  • Masticatory Muscles / virology
  • Middle Aged
  • Neoplasm Invasiveness / diagnostic imaging*
  • Neoplasm Recurrence, Local / etiology*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / virology
  • Oropharyngeal Neoplasms / diagnostic imaging*
  • Oropharyngeal Neoplasms / pathology
  • Oropharyngeal Neoplasms / virology
  • Papillomaviridae
  • Papillomavirus Infections / complications
  • Papillomavirus Infections / virology
  • Predictive Value of Tests
  • Preoperative Period
  • Radiography / methods
  • Radiography / statistics & numerical data*
  • Retrospective Studies