1. Outcomes of transoral robotic surgery for early-stage oropharyngeal squamous cell carcinoma with low rates of adjuvant therapy: A consecutive single-institution study from 2013 to 2020.
- Author
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Meldgaard Justesen M, Kronberg Jakobsen K, Fenger Carlander AL, Hjordt Holm Larsen M, Wessel I, Kiss K, Friborg J, Ibrahim Channir H, Rubek N, Grønhøj C, and von Buchwald C
- Subjects
- Humans, Male, Female, Middle Aged, Aged, Treatment Outcome, Adult, Neoplasm Recurrence, Local, Aged, 80 and over, Neoplasm Staging, Neck Dissection methods, Squamous Cell Carcinoma of Head and Neck surgery, Squamous Cell Carcinoma of Head and Neck therapy, Squamous Cell Carcinoma of Head and Neck mortality, Squamous Cell Carcinoma of Head and Neck pathology, Carcinoma, Squamous Cell surgery, Carcinoma, Squamous Cell therapy, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell mortality, Retrospective Studies, Robotic Surgical Procedures methods, Oropharyngeal Neoplasms surgery, Oropharyngeal Neoplasms therapy, Oropharyngeal Neoplasms mortality, Oropharyngeal Neoplasms pathology, Oropharyngeal Neoplasms virology
- Abstract
Introduction: The incidence of oropharyngeal squamous cell carcinoma (OPSCC) has increased in recent decades, driven by infection with human papillomavirus (HPV). Transoral robotic surgery (TORS) and neck dissection (ND) has been employed as an alternative to radiotherapy/chemoradiotherapy. The current literature is lacking studies providing an exhaustive overview of recurrence characteristics and long-term outcomes in TORS-treated OPSCC-patients., Methods: All patients treated for OPSCC with primary TORS + ND in Eastern Denmark between 2013 and 2020 were included in the study. The aim was to explore overall survival (OS), recurrence-free survival (RFS), recurrence patterns, and ultimate failure rate (UFR). OS and RFS were examined using the Kaplan-Meier method. Cox proportional regression analyses were employed to examine effect of different variables on risk of death and recurrence., Results: The study included 153 patients of which 88.9 % (n = 136) were treated with TORS alone while 11.1 % (n = 17) received adjuvant therapy. The 1-, 3-, and 5-year OS were 97.4 %, 94.1 %, and 87.6 % while 1-, 3-, and 5-year RFS were 96.6 %, 87.8 %, and 84.9 %. The UFR was 6.5 % in the cohort. Patients with HPV+/p16 + OPSCC had a significantly better 5-year OS of 92.3 % than patients with discordant or double-negative HPV/p16 status (OS = 73.3 %). No differences in outcomes between patients treated with or without adjuvant therapy were found in regression analysis., Conclusion: Excellent survival and disease control was obtained with TORS + ND in this cohort, despite lesser application of adjuvant therapy than other TORS-centers, implying that TORS without adjuvant therapy can be successfully applied in treatment of early-stage OPSCC., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2024
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