Increased rate of recurrence and high rate of salvage in patients with human papillomavirus – associated oropharyngeal squamous cell carcinoma with adverse features treated with primary surgery without recommended adjuvant therapy

Head & Neck ◽  
2020 ◽  
Author(s):  
Ryan M. Carey ◽  
David Shimunov ◽  
Gregory S. Weinstein ◽  
Steven B. Cannady ◽  
John N. Lukens ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Human Papillomavirus ◽  
Adjuvant Therapy ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Oropharyngeal Squamous Cell Carcinoma ◽  
High Rate ◽  
Primary Surgery

scholarly journals Identification of Clinical and Socioeconomic Predictors of Adjuvant Therapy after Trans-Oral Robotic Surgery in Patients with Oropharyngeal Squamous Cell Carcinoma

Cancers ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2474
Author(s):  
Sujith Baliga ◽  
Brett Klamer ◽  
Sachin Jhawar ◽  
Mauricio Gamez ◽  
Darrion Mitchell ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Robotic Surgery ◽  
Adjuvant Therapy ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Additional Treatment ◽  
Oropharyngeal Squamous Cell Carcinoma ◽  
High Rate ◽  
Adjuvant Radiation ◽  
Entire Cohort

Trans-oral robotic surgery (TORS) has emerged as an important surgical treatment option in the management of human papillomavirus (HPV)-positive and -negative oropharynx cancer. However, treatment selection is paramount to ensure that patients will not require multimodality adjuvant therapy. In this study, we determined predictors of adjuvant therapy in TORS-treated patients. The National Cancer Database (NCDB) was used to identify patients with newly diagnosed clinical T1-T4, N0-N3 oropharyngeal squamous cell carcinoma who underwent TORS between 2010–2016. Kaplan–Meier survival analysis was used to estimate overall survival (OS). A total of 2999 patients were studied, and the five-year OS for the entire cohort was 82.5%, and for HPV-positive and -negative cohorts it was 88.3% and 67.9%, respectively (p < 0.001). Among all patients treated with TORS, 35.1% of patients received no additional treatment, 33.5% received adjuvant radiation alone (RT), and 31.3% received adjuvant chemoradiation. The N stage was pathologically upstaged in 629 (20.9%) patients after TORS. Patients treated at higher-volume centers were more likely to have negative surgical margins (OR: 0.96, 95% CI: 0.94, 0.98, p < 0.001), but this did not influence the receipt of adjuvant therapy. The high rate of adjuvant multimodality treatment after TORS suggests a need for improved patient selection. Limitations of this study, including lack of data on loco-regional control, progression free survival, acute and late toxicities, and utilization of pretreatment PET/CT imaging, should be addressed in future studies.

Transoral robotic surgery for oropharyngeal squamous cell carcinoma in the era of human papillomavirus

Head & Neck ◽  
2017 ◽  
Vol 40 (4) ◽  
pp. 710-721 ◽  
Author(s):  
Omar Mahmoud ◽  
Kim Sung ◽  
Francisco J. Civantos ◽  
Giovanna R. Thomas ◽  
Michael A. Samuels
Keyword(s):  
Squamous Cell Carcinoma ◽  
Human Papillomavirus ◽  
Robotic Surgery ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Transoral Robotic Surgery ◽  
Oropharyngeal Squamous Cell Carcinoma
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