Predictive Nomogram for Risk Stratification After Transoral Surgery in HPV-Related Oropharyngeal Cancer.

Abstract

This study develops a predictive model that stratifies patients with HPV-related oropharyngeal squamous cell carcinoma (OPSCC) by survival outcomes based on adjuvant treatment received following transoral surgery (TOS). Patients receiving primary TOS with or without adjuvant were included from the National Cancer Database. A predictive nomogram was constructed using a multivariable Cox regression model. A total of 5569 patients were included. The model based on 11 demographic, socioeconomic, and clinical variables stratified patients into low-risk (57%), intermediate-risk (35.5%), and high-risk (7.5%) cohorts, with significant differences in survival between the risk groups. No association with better survival was found for adjuvant treatment in the low-risk group. A significant association between adjuvant treatment and improved survival was measured in the intermediate-risk and high-risk cohorts. This predictive model effectively stratified OPSCC patients by risk, revealing outcome differences based on adjuvant treatment. Further studies are required to validate these findings.