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. 2022 Jun 12;12(6):1443.
doi: 10.3390/diagnostics12061443.

Prognostic Value of Pathologically Positive Nodal Number in p16-Negative Oropharyngeal and Hypopharyngeal Squamous Cell Carcinoma with pN3b Status

Ming-Hsien Tsai  1   2   3 , Yu-Tsai Lin  1   2   3 , Hui-Ching Chuang  1   2   4 , Tai-Ling Huang  2   5 , Hui Lu  1 , Chih-Yen Chien  1   2   4   6 , Fu-Min Fang  2   4   7
Affiliations

Prognostic Value of Pathologically Positive Nodal Number in p16-Negative Oropharyngeal and Hypopharyngeal Squamous Cell Carcinoma with pN3b Status

Ming-Hsien Tsai et al. Diagnostics (Basel). .

Abstract

In this study, we aimed to investigate the prognostic value of the number of pathologically positive nodes (pN+) in p16-negative oropharyngeal (OPSCC) and hypopharyngeal (HPSCC) squamous cell carcinoma cases with pN3b status after surgery. We reviewed the clinical and pathological features of 120 newly diagnosed p16-negative OPSCC and HPSCC patients with pN3b status after radical surgery. The primary endpoints were the 5-year overall survival (OS), cancer-specific survival (CSS), and their prognostic factors. We used the Cox proportional hazards model for survival analysis. We generated predictive nomograms that incorporated the clinicopathological factors of OS and CSS. The 5-year OS and CSS rates were 44.1% and 59.1%, respectively. The optimal number of pN+ to predict the 5-year OS and CSS was pN+ = 3. In the Cox model, we observed that pN+ ≥ 3 was a significantly negative predictor of OS (HR: 1.9, 95% CI: 1.1-3.2, p = 0.021) and CSS (HR: 2.3; 95% CI: 1.2-4.6; p = 0.015). After adding the pN+ variable, the c-index of the predictive nomogram incorporating assorted clinicopathological factors increased from 0.66 to 0.689 for OS and from 0.713 to 0.75 for CSS. The results highlight the prognostic value of the pN+ number in p16-negative OPSCC and HPSCC patients with pN3b status.

Keywords: extranodal extension; hypopharyngeal cancer; nomogram; oropharyngeal cancer; pathologically positive nodal number.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier survival curves according to different numbers of positive nodes: (A) overall survival curves and (B) cancer-specific survival curves.
Figure 2
Figure 2
Kaplan–Meier survival curves among p16-negative OPSCC and HPSCC patients with two different categories of numbers of positive nodes (pN+): (A) overall survival curves and (B) cancer-specific survival curves.
Figure 3
Figure 3
Nomogram and survival predictions: (A) nomogram for OS prediction and (C) nomogram for CSS prediction. A vertical line is drawn from each factor to the point score. By adding the points from all factors, a total points score is reached, which is translated into 5-year OS probabilities by drawing a vertical line to its axis. (B) Calibration plots of the nomogram to predict 5-year OS, and (D) calibration plots of the nomogram to predict 5-year CSS. The 45-degree straight line indicates the ideal prediction, and the dark-gray line represents the nomogram’s performance. Gray dots with bars represent the nomogram’s performance with 95% CI when applied to the observed surviving cohorts.
See this image and copyright information in PMC

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