Will My Throat Cancer Spread?

Throat cancers with matted lymph nodes more likely to metastasize

(RxWiki News) One of the biggest fears a cancer patient faces is spread of the disease. Metastasis is never a good thing, but it's usually hard to predict which cancers will travel. Researchers are solving this mystery in throat cancer.

Throat cancer patients who have lymph nodes that are "matted" or connected together are more likely to see the disease spread to other parts of their body.

"Ask your oncologist about ways to predict your disease course."

In a recent study, University of Michigan Health System researchers have found that the lymph nodes can be good indicators of a common form of throat cancer metastasis.

Senior study author, Douglas B. Chepeha, M.D., M.S.P.H., an associate professor of otolaryngology head and neck surgery at the U-M Medical School, said "Our findings may help doctors identify patients who are at higher risk for having their cancer metastasize and who would benefit from additional systemic therapy.

"Conversely, some patients without matted nodes may benefit from a reduction of the current standard treatment, which would cut down on uncomfortable side effects," Dr. Chepeha went on to explain in a press release describing the research.

For the study, investigators followed 78 patients diagnosed with stage III or IV squamous cell carcinoma of the oropharynx. These individuals were participating in a clinical trial testing the effectiveness of two cancer drugs in combination with radiation therapy.

A total of 16 patients had matted nodes. These patients did not live as long as those who didn't have the connected nodes.

This indicator was not affected by other known risk factors that can predict the course of throat cancer, including a person's smoking (tobacco and marijuana), alcohol consumption and human papillomavirus (HPV) infection.

Dr. Chepeha and colleagues discovered that matted lymph nodes were particularly strong predictors for those who are HPV-positive, despite the fact that these patients generally fare better than people who don't have the HPV infection.

The best outcomes are seen in non-smokers who are HPV-positive.

Lead author Matthew E. Spector, M.D., a head and neck surgery resident at U-M who won a national award from the American Head and Neck Society for this work. says it's not clear why lymph nodes are predictive.

"It is possible that there are biological and molecular differences in these types of tumors, which can be explored in future research,"  Dr. Spector said.

This research was published online January 13, 2012 ahead of the print edition of the journal Head & Neck.

Funding from the Specialized Program of Research Excellence (SPORE) in Head and Neck Cancer grant from the National Cancer Institute supported this research.

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Review Date: 
January 16, 2012