Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P80

Head and Neck

P80
Otolaryngology-Head and Neck Surgery 163(1S)
Presentation schedule is subject to change. The Official Program Abstracts supplement does not reflect changes made after August 10, 2020.
reported to be as high as 10%. This has led some to recomConclusions: Patients with malnutrition may be at greater
mend elective contralateral tonsillectomy in all patients underrisk of experiencing postoperative complications after total
going surgical treatment for OPSCC. We systematically
laryngectomy. Further study into the effects of preoperative
reviewed the literature to determine the prevalence of second
indicators of malnutrition such as albumin may be useful.
primary OPSCC.
Methods: Search strategies created with a librarian were
Significance of Microscopic Extranodal
implemented in multiple databases and completed in October
Extension in HPV-Negative Head and
2019. Population of interest were adults age > 18 years old
Neck Cancer and the Role of Adjuvant
with a p16+ or human papillomavirus+ OPSCC. Outcome was
Chemoradiation
a second primary OPSCC. Inclusion and exclusion criteria
Flora Yan (Presenter); John M. Kaczmar, MD; Anand K.
were designed to capture all study designs. Two reviewers
Sharma, MD; Terry A. Day, MD; Evan M. Graboyes, MD
independently performed the review, extracted data, and perObjectives: Background: Pathologic extranodal extension
formed a quality assessment. Preferred Reporting Items for
(ENE) is a well-recognized adverse feature for patients with
Systematic Reviews and Meta-Analyses (PRISMA) guidehuman papillomavirus (HPV)-negative head and neck squalines were followed.
mous cell carcinoma (HNSCC); standard of care following
Results: From 13 studies 2091 patients were identified, of
surgery is adjuvant chemoradiation (CRT). The eighth edition
which 33 developed a second primary OPSCC. The pooled
American Joint Committee on Cancer (AJCC) distinguishes
prevalence was 1.6% and ranged from 0 to 10.5% in the
between microscopic (ENEmi) and macroscopic ENE (≤ 2
included studies. Of the 19 patients with available information
mm; > 2 mm). Whether ENEmi confers a worse prognosis is
on the second primary location within the oropharynx, 13
unknown. In addition, whether adjuvant CRT improves sur(68.4%) were in the tonsil, 5 (26.3%) were in the tongue base,
vival relative to adjuvant radiation therapy (RT) for patients
and 1 (5.3%) was in the soft palate. Of 19 patients with metawith ENEmi has not been evaluated.
chronous tumors and survival information, 14 (73.7%) patients
Methods: Patients with HPV-negative HNSCC undergoing
were successfully treated, 4 (21.1%) patients ultimately died of
margin-negative surgery and neck dissection who were node
disease, and 1 (5.3%) patient was currently alive with disease.
positive (N+) without ENE (ENE-) or N+ with ENEmi were
Conclusions: Overall, the rate of clinically significant secidentified from the National Cancer Database from 2004 to
ond primary OPSCC is low and the majority are successfully
2015. The association of ENEmi with overall survival (OS)
treated. This information will be valuable to surgeons contemand the effect of adjuvant CRT in patients with ENEmi was
plating performing an elective tonsillectomy during surgical
evaluated using univariable and multivariable Cox regression
treatment of OPSCC.
analyses.
Results: We included 5399 patients of whom 23.9% had
TCGA Deconvolution Uncovers T Cell
ENEmi and 76.1% were N+/ENE-. On multivariable analysis
Subtypes Associated With Survival in
adjusting for demographics, tumor characteristics, and adjuHNSCC
vant treatment, ENEmi was associated with worse OS over
Anuraag S. Parikh, MD (Presenter); Yize Li; Angela
N+/ENE- disease (adjusted hazard ratio [aHR] 1.50; 95% CI,
Mazul, PhD, MPH; Zongtai Qi; Li Ding; Sidharth V. Puram, MD
1.37-1.65). Among ENEmi patients who received adjuvant
Objectives: The Cancer Genome Atlas (TCGA) has protherapy (n = 950), multivariable analysis adjusting for demovided a wealth of bulk sequencing data, but systematic decongraphics and tumor characteristics did not find adjuvant CRT
volution of these data to assess the impact of individual
to improve OS over RT (aHR 0.83; 95% CI, 0.67-1.03).
immune cell types has not been performed in head and neck
Conclusions: For patients with HPV-negative HNSCC
squamous cell carcinoma (HNSCC).
treated with margin-negative surgery and neck dissection,
Methods: Transcriptomic data for 562 oral cavity, oropharENEmi disease is associated with worse OS. However, adjuynx, and larynx SCC patients were obtained from TCGA.
vant CRT does not improve OS for patients with ENEmi.
Using the CIBERSORT algorithm, signatures of 21 resting and
Additional prospective studies are necessary to evaluate the
activated subtypes of B cells, T cells, NK cells, macrophages,
role of adjuvant CRT for ENEmi and determine optimal treatdendritic cells, mast cells, eosinophils, and neutrophils were
ment paradigm.
used to deconvolve bulk data and quantify relative proportions
of these cell types across tumors. Univariate and multivariate
Systematic Review of Second Primary
Cox proportional hazards models were used to determine the
Oropharyngeal Cancers Among Patients
association of these cell types with disease subsite, global
With p16+ Oropharyngeal Cancer
expression subtypes, and disease-free survival (DFS).
Craig A. Bollig, MD (Presenter); David S. Lee;
Results: Proportions of immune cell types were highly variRyan S. Jackson, MD; Patrik Pipkorn, MD
able across tumors. In the univariate analyses, numerous B
cell, T cell, and macrophage subpopulations were associated
Objectives: The rate of second primary oropharyngeal canwith subsite and expression subtype. By contrast, there were
cers in patients with p16+ squamous cell carcinoma of the
few associations with disease stage, as expected. In
oropharynx (OPSCC) is not well understood but has been

Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts

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