Does Tumor Volume Have a Prognostic Role in Oropharyngeal Squamous Cell Carcinoma? A Systematic Review and Meta-Analysis

SIMPLE SUMMARY: Increasing evidence supports the role of tumor volume as a prognostic marker in head and neck cancer (HNC), specifically, in the glottis, supraglottis, hypopharynx and nasopharynx treated by primary radiotherapy. However, studies on oropharyngeal carcinomas have yielded mixed results. We performed a systematic review and meta-analysis to assess the prognostic value of tumor volume in oropharyngeal squamous cell carcinoma (OPSCC). In particular, we calculated the hazard ratio (HR) of overall survival (OS), disease-free survival (DFS) and locoregional control (LRC) of high values for primary and nodal tumor volume (pTV and nTV, respectively), compared to those of low values. Our findings based on 1417 patients with OPSCC showed that pTV and nTV are not predictors of OS, and they may not be used as prognostic factors in OPSCCs. Moreover, the difference in terms of DFS and LRC was too small to appear clinically relevant. ABSTRACT: The aim of this study was to assess the prognostic value of tumor volume in oropharyngeal squamous cell carcinoma (OPSCC). The study was performed according to the PRISMA guidelines. A total of 1417 patients with a median age of 59.3 years (IQR 57.5–60) were included. The combined Hazard Ratios (HRs) for overall survival (OS) were 1.02 (95% CI, 0.99–1.05; p = 0.21) for primary tumor volume (pTV) and 1.01 (95% CI, 1.00–1.02; p = 0.15) for nodal tumor volume (nTV). Regarding locoregional control (LRC), the pooled HRs were 1.07 (95% CI, 0.99–1.17; p = 0.10) for pTV and 1.02 (95% CI, 1.01–1.03; p < 0.05) for nTV. Finally, the pooled HRs for disease-free survival (DFS) were 1.01 (95% CI, 1.00–1.03; p < 0.05) for pTV and 1.02 (95% CI, 1.01–1.03; p < 0.05) for nTV. In conclusion, pTV and nTV seem not to behave as reliable prognostic factors in OPSCC.