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

Head & neck 2026 Vol.48(2) p. 457-467

Costantino A, Paleri V, Holsinger FC, Alamoudi U, Haughey BH, Magnuson JS

Abstract

[BACKGROUND] 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).

[METHODS] 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.

[RESULTS] 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.

[CONCLUSIONS] This predictive model effectively stratified OPSCC patients by risk, revealing outcome differences based on adjuvant treatment. Further studies are required to validate these findings.

MeSH Terms

Humans; Oropharyngeal Neoplasms; Nomograms; Male; Female; Middle Aged; Risk Assessment; Aged; Papillomavirus Infections; Carcinoma, Squamous Cell; Retrospective Studies; Proportional Hazards Models; Adult; Natural Orifice Endoscopic Surgery; Databases, Factual