Meta-analysis of histopathological prognostic factors in surgically treated HPV-associated oropharyngeal squamous cell carcinoma

HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) is rising in prevalence. In surgically treated patients with HPV-negative OPSCC, adverse pathologic features such as positive surgical margins, extranodal extension (ENE) and perineural invasion are well described to portend worse clinical outcomes. Meta-analysis of32 studies, comprising 31,535 surgically treated patients with HPV-positive OPSCC, investigated the relationship of 13 histopathologic factors with clinical outcomes. In meta-analysis, ENE and advanced pT stage were associated with poorer overall survival, disease-specific survival, and disease-free survival. Lymphovascular invasion and positive margins were associated with poorer overall survival. The authors conclude that the presence of these factors should be carefully evaluated for optimal treatment decisions.