Definitive Surgical Therapy after Open Neck Biopsy for HPV-Related Oropharyngeal Cancer. (April 2016)

• Record Type: Journal Article
• Authors: Zenga, Joseph; Graboyes, Evan M.; Haughey, Bruce H.; Paniello, Randal C.; Mehrad, Mitra; Lewis, James S.; Thorstad, Wade L.; Nussenbaum, Brian; Rich, Jason T.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 154:Number 4(2016:Apr.)
• Page Start: 657
• Page End: 666
• Publication Date: 2016-04
• Subjects: open neck biopsy -- incisional biopsy -- excisional biopsy -- oropharyngeal carcinoma -- p16 -- HPV -- human papillomavirus -- transoral surgery -- TLM; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599815627642
• Languages: English
• ISSNs: 0194-5998

Abstract

Objective: To determine the impact of prior open neck biopsy on the prognosis of patients with human papillomavirus (HPV)–related oropharyngeal squamous cell carcinoma (OPSCC) who are subsequently treated with a definitive surgical paradigm, including adjuvant therapy when indicated. Study Design: Retrospective cohort. Setting: Tertiary care university hospital. Subjects and Methods: Patients with open neck biopsies who were treated with definitive surgery, with or without adjuvant therapy, for HPV-related OPSCC between 1998 and 2012 were compared with a matched control group who did not undergo open neck biopsy. Outcomes were disease-free survival, overall survival, disease-specific survival, incidence of tumor deposit in dermal scar, patterns of recurrence, and neck dissection complications. Results: Forty-five patients who underwent open neck biopsy were compared with 90 matched controls. Tumor deposits in dermal scars from the prior open neck biopsy were found in 3 patients (7%) during completion neck dissection. Overall complications of the neck dissection were not significantly increased in the open biopsy group over matched controls (20% vs 12%, respectively; P > .05). Five-year Kaplan-Meier estimates for disease-free survival, overall survival, and disease-specific survival were not significantly different between the open biopsy and control groups (93% vs 91%, 98% vs 97%, 98% vs 99%, respectively; all P > .05). Recurrence rates were also not significantly different between groups. Conclusions: Patients with HPV-related OPSCC who have undergone a prior open neck biopsy can be successfully treated with a definitive surgical paradigm. Although needle biopsy is preferable to establish a diagnosis, previous open neck biopsy does not affect prognosis in these patients.