Issues

The cover image is adapted from Figure 3 in the article “Impact of Nodal Metastases in HPV-negative Oropharyngeal Cancer,” by Chang and colleagues. The original image shows balloon plots depicting proportion of patients presenting with various Tumor and Nodal status in the SEER and NCDB cohorts. The updated American Joint Committee on Cancer (AJCC) 8th Edition staging manual restructured nodal classification and staging by placing less prognostic emphasis on nodal metastases for HPV-positive oropharyngeal squamous cell carcinoma (OPSCC). However, there was no change for HPV-negative OPSCC. The purpose of this study was to examine the impact of nodal metastases on survival in HPV-negative OPSCC. The authors analyzed two national cancer registries, the National Cancer Database (NCDB) and the Surveillance, Epidemiology and End Results program (SEER), to investigate the impact of nodal metastasis on survival and recurrence in HPV-negative OPSCC patients. The authors demonstrated that when nodal staging is de-emphasized as a part of overall staging, there is improved concordance and risk stratification for HPV-negative OPSCC. The exact mechanism of this differential impact remains unknown but offers a novel area of study. For more information, see the article beginning on page 1554.