Prophylactic contralateral neck dissection has no advantage in patients with early stage HPV-positive tonsil cancer

ABSTRACT 

Background

Patients with locally advanced HPV-positive tonsil cancer would benefit from prophylactic contralateral neck dissection (pCND).

Aims/Objectives

The aim of this study was to analyze rates of contralateral lymph node metastases (LNM) and their prognostic effects on locally advanced HPV-positive tonsillar squamous cell carcinoma.

Materials and methods

Medical records of 54 patients who underwent upfront primary surgery and pCND were retrospectively reviewed.

Results

Six (11.1%) patients had contralateral LNM in 54 locally advanced HPV-positive tonsil cancer. Of these, five patients had contralateral level II LNM and one patient had contralateral level II and III LNM. Contralateral LNM showed significant positive correlations with advanced T stage (p = .017) and the presence of extracapsular spread (p = .007). Contralateral lymph node metastasis had no significant association with five-year disease-specific survival.

Conclusions and significance

This study demonstrated no advantage in performing pCND in early stage HPV-positive tonsil cancer.

Chinese Abstract

背景：局部晚期 HPV 阳性扁桃体癌患者将受益于预防性对侧颈清扫术 (pCND)。

目的：本研究的目的是分析对侧淋巴结转移 (LNM) 的发生率及其对局部晚期 HPV 阳性扁桃体鳞状细胞癌的预后影响。

材料和方法：回顾性审查了接受前期初次手术和 pCND 的 54 名患者的医疗记录。

结果：在 54 例局部晚期 HPV 阳性扁桃体癌中, 6 名（11.1%）患者有对侧 LNM。其中, 5 名患者有对侧 II 级 LNM, 1 名患者有对侧 II 级和 III 级 LNM。对侧 LNM 与晚期 T 期 (p = .017) 和包膜外扩散 (p = .007) 呈显著正相关。对侧淋巴结转移与五年疾病特异性生存率无显著相关性。

结论和意义：本研究表明, 对早期 HPV 阳性扁桃体癌行 pCND 没有优势。

Keywords:

• Squamous cell carcinoma
• tonsillar neoplasms
• papillomavirus infections
• lymphatic metastasis
• tumor burden

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

This work was supported by the Korea Medical Device Development Fund grant funded by the Korea government (the Ministry of Science and ICT, the Ministry of Trade, Industry and Energy, the Ministry of Health & Welfare, the Ministry of Food and Drug Safety) [Project Number: 202011D15].