Journal
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
Volume 38, Issue 8, Pages 1263-1270Publisher
WILEY-BLACKWELL
DOI: 10.1002/hed.24432
Keywords
carcinoma; squamous cell; surgery; oropharyngeal neoplasms; surgery; laser therapy; methods; oropharyngeal neoplasms; mortality; neoplasm recurrence; local; survival analysis
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Funding
- Cancer Research UK [17161] Funding Source: researchfish
- National Institute for Health Research [ACF-2012-07-007, ACF-2016-07-006] Funding Source: researchfish
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BackgroundThe contemporary treatment of oropharyngeal squamous cell carcinoma (SCC) is an area of debate. We report outcomes of a minimally invasive approach involving transoral laser microsurgery (TLM). MethodsA consecutive series of patients (n = 153) undergoing primary TLM for oropharyngeal SCC from 2006 to 2013 was studied. Human papillomavirus (HPV) status was determined by p16 immunohistochemistry and high-risk HPV DNA in situ hybridization. Survival analyses were evaluated using Kaplan-Meier statistics. ResultsTumor subsites included tonsil (n = 94; 61.5%), tongue base (n = 38; 24.8%), and soft palate (n = 21; 13.7%), with the majority being American Joint Committee on Cancer (AJCC) stage III/IVa (n = 124; 81.0%) and HPV-positive (n = 101; 66.0%). Three-year overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS) were 84.5%, 91.7%, and 78.2%, respectively. HPV-positivity portended favorable oncologic outcomes. One-year gastrostomy tube (G-tube) dependency was 1.3%. ConclusionTo the best of our knowledge, this is the largest single-center TLM oropharyngeal SCC series to date. Our data suggest that TLM +/- postoperative radiotherapy (PORT) results in at least as good oncologic outcomes as chemoradiotherapy (CRT), while conferring swallowing function advantages. (c) 2016 Wiley Periodicals, Inc. Head Neck , 2016 (c) 2016 Wiley Periodicals, Inc. Head Neck 38:1263-1270, 2016
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