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Predictive Nomogram for Risk Stratification After Transoral Surgery in HPV-Related Oropharyngeal Cancer
Andrea Costantino1, Vinidh Paleri2,3,4, F Christopher Holsinger5
1Department of Otolaryngology-Head and Neck Surgery, AdventHealth Orlando, Orlando, Florida, USA.
Background:
This study develops a predictive model that stratifies patients with HPV-related oropharyngeal squamous cell carcinoma (OPSCC) by survival outcomes based on adjuvant treatment received following transoral surgery (TOS).
Methods:
Patients receiving primary TOS with or without adjuvant were included from the National Cancer Database. A predictive nomogram was constructed using a multivariable Cox regression model.
Results:
A total of 5569 patients were included. The model based on 11 demographic, socioeconomic, and clinical variables stratified patients into low-risk (57%), intermediate-risk (35.5%), and high-risk (7.5%) cohorts, with significant differences in survival between the risk groups. No association with better survival was found for adjuvant treatment in the low-risk group. A significant association between adjuvant treatment and improved survival was measured in the intermediate-risk and high-risk cohorts.
Conclusions:
This predictive model effectively stratified OPSCC patients by risk, revealing outcome differences based on adjuvant treatment. Further studies are required to validate these findings.
