A matched pair analysis of oncological outcomes in human papillomavirus‐negative oropharyngeal squamous cell carcinoma: Transoral surgery versus radiotherapy or concurrent chemoradiation. Issue 10 (29th May 2021)

• Record Type: Journal Article
• Authors: Thakar, Alok; Panda, Smriti; Kakkar, Aanchal; Singh, Vishwajeet; Singh, Chirom Amit; Sharma, Atul; Bhasker, Suman; Krishnamurthy, Padmavathi; Sharma, Suresh C.
• Is Part Of: Head & neck. Volume 43:Issue 10(2021)
• Page Start: 2896
• Page End: 2906
• Publication Date: 2021-05-29
• Subjects: chemoradiation -- human papillomavirus -- radiotherapy -- transoral robotic surgery -- transoral ultrasonic surgery; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.26771
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: Background: With the termination of RTOG 1221, there remains a lacuna regarding the optimal treatment for human papillomavirus (HPV)‐negative oropharyngeal squamous cell carcinoma (OPSCC). Methods: Matched pair analysis with propensity score matching (PSM) between Arm I (transoral surgery [TOS] + risk‐stratified adjuvant treatment) and Arm II (nonsurgical treatment − radiation/chemoradiation) in HPV(−) OPSCC. Results: Unmatched comparison of Arm I ( n = 57) and Arm II ( n = 89) indicated significantly better overall survival (OS) and disease‐free survival (DFS) for Arm I. PSM by matched pairs ( n = 48, 24 each arm) indicated 5‐year OS at 80% and 72.1%, respectively, for Arm I and II ( p > 0.05) and corresponding DFS at 65.3% and 33.4% ( p > 0.05). Subgroup analysis did not demonstrate statistical difference in outcomes in stage II and III, but stage IV tumors had significantly better outcomes in Arm I than Arm II (4‐year OS: 100% vs. 21%, p = 0.04; DFS: 75% vs. 14.3%, p = 0.04). Conclusions: TOS +/− adjuvant was found to have oncological outcomes at par with nonsurgical modalities in stage I–III OPSCC, whereas a distinct survival advantage was noted in case of stage IV tumors.