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Tumor Volume as a Prognostic Factor in Oropharyngeal Squamous Cell Carcinoma Treated With Primary Radiotherapy

Authors

  • Mark J. Been BS,

    1. From the Departments of Surgery, Division of Otolaryngology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.
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  • Joanna Watkins MD,

    1. From the Departments of Surgery, Division of Otolaryngology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.
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  • Ryan M. Manz MD,

    1. From the Departments of Surgery, Division of Otolaryngology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.
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  • Lindell R. Gentry MD,

    1. From the Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.
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  • Glen E. Leverson PhD,

    1. From the Surgery Biostatistics Office, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.
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  • Paul M. Harari MD,

    1. From the Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.
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  • Gregory K. Hartig MD

    Corresponding author
    1. From the Departments of Surgery, Division of Otolaryngology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.
    • Send correspondence to Gregory Hartig, MD, K4/720 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792
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Abstract

Objectives/Hypothesis: Tumor volume has been demonstrated to play a prognostic role in many head and neck cancers. The purpose of this study was to conduct an institutional review analyzing the correlation between tumor volume and locoregional control of oropharyngeal squamous cell cancer treated with primary radiotherapy.

Study Design: Retrospective institutional chart analysis.

Methods: Seventy-nine patients from 1991 to 2005 with primary T1 to T4 oropharyngeal squamous cell carcinoma (base of tongue, n = 31; soft palate, n = 1; tonsils, n = 47) were treated with primary radiotherapy. Tumor volumes were measured from pretreatment computerized tomography scans by two observers. Three-dimensional tumor volumes were calculated using a computer digitizer for each computed tomography slice showing the primary lesion. Survival analysis, using the methods of Kaplan and Meier, was performed to assess whether tumor volume, Tumor, Node, Metastasis classification, tumor stage, or location were associated with locoregional failure.

Results: Tumor volume did not significantly correlate with locoregional failure (observer 1, P = .6244; observer 2, P = .5612). There was a high interobserver correlation (r = 0.98970). Univariate analysis did, however, demonstrate a significant difference in locoregional failure between T4 tumors and all other T stages (T1 vs. T4, P = .0107; T2 vs. T4, P = .0004; T3 vs. T4, P = .0155). Nodal status, tumor stage, and location did not significantly correlate with locoregional failure rate.

Conclusions: Tumor volume does not appear to play a significant role in predicting locoregional recurrence for patients with primary squamous cell cancer of the oropharynx treated with primary radiotherapy. However, T4 status was predictive of poor locoregional control.

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