Composite Pathologic Risk Stratification of Cramer et al for Human Papillomavirus (HPV)-Associated Oropharyngeal Squamous Cell Carcinoma

Description

Cramer et al evaluated patients with surgically-resected human papillomavirus (HPV)- associated squamous cell carcinomas of the oropharynx. They reported a composite pathologic risk stratification model which can identify a patient who may benefit from more aggressive management. The authors are from Wayne State University in Detroit.

Patient selection: HPV-associated oropharyngeal squamous cell cancer, srugically-resected

Parameters:

(1) T classification

(2) number of metastatic lymph nodes

(3) lymphovascular invasion

(4) extranodal extension

(5) surgical margins

Parameter	Finding	Points
T classification	T1 or T2	0
	T3	2
	T4	3
LN metastases	0 to 1	0
	2 to 4	2
	>= 5	3
lymphovascular invasion	none	0
	present	1
extranodal extension	none	0
	microscopic	1
	macroscopic	2
surgical margins	negative	0
	microscopically positive	1
	macroscopically positive	2

total score =

= SUM(points for all of the parameters)

Interpretation:

• minimum score: 0

• maximum score: 11

Scoer	Risk Group	5-Year Overall Survival
<= 3	low	92%
4 or 5	intermediate	83%
>= 6	high	53%

Therapy with adjuvant radiotherapy or chemoradiation improved outcome for intermediate and high risk patients.

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Composite Pathologic Risk Stratification of Cramer et al for Human Papillomavirus (HPV)-Associated Oropharyngeal Squamous Cell Carcinoma

Description

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