Matted Lymph Nodes ID Poor Oropharyngeal SCC Prognosis

Patients with matted nodes have worse survival, independent of other known prognostic factors

FRIDAY, Jan. 20 (HealthDay News) -- Patients with oropharyngeal squamous cell carcinoma (SCC) who present with matted nodes have a worse prognosis than those without matted nodes, according to a study published online Jan. 13 in Head & Neck.

Matthew E. Spector, M.D., from the University of Michigan Health System in Ann Arbor, and colleagues investigated the correlation between patterns of local-regional tumor extent and distant metastasis in 78 untreated patients with oropharyngeal SCC, who were participating in a concurrent chemoradiation protocol. Human papillomavirus (HPV) in situ hybridization and epidermal growth factor receptor immunointensity were assessed. Of the 78 patients, 16 had matted lymph nodes.

The researchers found that the three-year disease-specific survival was 94 percent for patients without matted lymph nodes versus 69 percent for patients with matted lymph nodes (P = 0.003). The lower survival associated with matted nodes was independent of known prognostic factors, including T classification, HPV status, epidermal growth factor receptor status, and smoking status. Seven of the 11 patients who were HPV positive died of distant metastases, and matted nodes were seen in six of the seven with distant metastases.

"Matted nodes are a novel marker of poor prognosis in oropharyngeal SCC, independent of established prognostic factors. Matted nodes may identify patients at risk for the development of distant metastasis who could benefit from systemic therapy," the authors write.

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