Related Experiment Video
Updated: Jul 7, 2026
An Orthotopic Endometrial Cancer Model with Retroperitoneal Lymphadenopathy Made From In Vivo Propagated and Cultured VX2 Cells
Published on: September 12, 2019
Extra-capsular nodal extension after surgical resection for HPV-positive oropharyngeal Cancer: Adjuvant radiation
Allen M Chen1, Tjoson Tjoa2, William B Armstrong2
1Department of Radiation Oncology, Chao Family Comprehensive Cancer Center, University of California- Irvine, School of Medicine, Irvine, CA 92617, United States of America.
Purpose:
The prognostic significance of extra-capsular nodal extension (ECE) after surgical resection for human papillomavirus (HPV)-positive oropharyngeal cancer is controversial, and the optimal choice of adjuvant therapy is uncertain in this setting.
Methods And Materials:
A review of institutional databases identified a total of 63 patients with pathological evidence of ECE in at least 1 cervical lymph node after transoral robotic surgery and neck dissection for HPV-positive squamous cell carcinoma of the oropharynx. Clinical outcomes were compared based on whether patients received adjuvant radiation (20 patients) or chemoradiation (43 patients). The Kaplan Meier method was used to determine survival statistics with comparisons between groups conducted with the log-rank test.
Results:
With a median follow-up of 50 months (range, 6 to 110 months), the 3-year overall survival for the entire population was 87 %. No significant difference was observed between patients treated by adjuvant radiation and chemoradiation with respect to 3-year overall survival (86 % versus 87 %, p = 0.45), local-regional control (91 % vs. 90 %, p = 0.71), and progression-free survival (83 % vs. 85 %, p = 0.57). Exploratory subset analysis of competing variables failed to identify any group in which the addition of chemotherapy to radiation improved outcome.
Conclusions:
While the presence of ECE after surgical resection has historically been considered an indication for the use of concurrent chemoradiation in the adjuvant setting, these data suggest that this paradigm should be re-evaluated in the setting of HPV-positive oropharyngeal cancer.
