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A comparison of oncological outcomes between transoral surgical and non-surgical treatment protocols in the management of oropharyngeal squamous cell carcinoma

Published online by Cambridge University Press:  08 May 2017

S S Kao ,
J Micklem ,
E Ofo ,
S Edwards ,
D Dhatrak ,
A Foreman ,
S Krishnan  and
J-C Hodge
S S Kao*
Affiliation:
Department of ENT Head and Neck Surgery, Royal Adelaide Hospital, South Australia, Australia
J Micklem
Affiliation:
Department of ENT Head and Neck Surgery, Royal Adelaide Hospital, South Australia, Australia
E Ofo
Affiliation:
Department of ENT Head and Neck Surgery, Royal Adelaide Hospital, South Australia, Australia
S Edwards
Affiliation:
School of Public Health, University of Adelaide, South Australia, Australia
D Dhatrak
Affiliation:
Department of Anatomical Pathology, SA Pathology, Royal Adelaide Hospital, South Australia, Australia
A Foreman
Affiliation:
Department of ENT Head and Neck Surgery, Royal Adelaide Hospital, South Australia, Australia
S Krishnan
Affiliation:
Department of ENT Head and Neck Surgery, Royal Adelaide Hospital, South Australia, Australia
J-C Hodge
Affiliation:
Department of ENT Head and Neck Surgery, Royal Adelaide Hospital, South Australia, Australia
*
Address for correspondence: Dr Stephen Shih-Teng Kao, Department of ENT Head and Neck Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia E-mail: [email protected]
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Abstract

Background:

The incidence of oropharyngeal squamous cell carcinoma in the Western world is increasing, with the human papillomavirus epidemic implicated in this observed trend. The optimal treatment modality is yet undetermined regarding oncological outcomes.

Methods:

This study comprised 98 patients with oropharyngeal squamous cell carcinoma, treated with either primary transoral surgery with adjuvant therapy or primary chemoradiotherapy with curative intent, between 2008 and 2012. Clinicopathological characteristics including tumour–node–metastasis stage, human papillomavirus status, treatment modality, recurrence and overall survival were collated.

Results:

Five per cent of primary surgical patients had locoregional recurrences compared with 25 per cent of primary chemoradiotherapy patients. A lower rate of locoregional recurrence was observed in the human papillomavirus positive group.

Conclusion:

This paper reports higher rates of overall survival and local control for oropharyngeal squamous cell carcinoma treated with primary surgery compared with primary chemoradiotherapy. This reflects overall lower tumour stage and higher human papillomavirus status in this group.

Keywords

OropharynxSquamous Cell CarcinomaRobotic Surgical ProceduresRecurrenceHuman Papilloma Virus
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 4 , April 2018 , pp. 349 - 355
Copyright
Copyright © JLO (1984) Limited 2017 

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Footnotes

Presented orally at the New Zealand Society of Head and Neck Surgery Meeting, 20–23 October 2015, Nelson, New Zealand, and at the Japan-Taiwan Head and Neck Society Conference Meeting, 3–4 December 2015, Tokyo, Japan.

References

1Wyss, A, Hashibe, M, Chuang, SC, Lee, YC, Zhang, ZF, Yu, GP et al. Cigarette, cigar, and pipe smoking and the risk of head and neck cancers: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. Am J Epidemiol 2013;178:679–90Google Scholar
2Bagnardi, V, Rota, M, Botteri, E, Tramacere, I, Islami, F, Fedirko, V et al. Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis. Br J Cancer 2015;112:580–93Google Scholar
3Chaturvedi, AK, Engels, EA, Pfeiffer, RM, Hernandez, BY, Xiao, W, Kim, E et al. Human papillomavirus and rising oropharyngeal cancer incidence in the United States. J Clin Oncol 2011;29:4294–301Google Scholar
4Chaturvedi, AK, Engels, EA, Anderson, WF, Gillison, ML. Incidence trends for human papillomavirus-related and -unrelated oral squamous cell carcinomas in the United States. J Clin Oncol 2008;26:612–19Google Scholar
5Gillison, ML. Human papillomavirus-related diseases: oropharynx cancers and potential implications for adolescent HPV vaccination. J Adolesc Health 2008;43:S52–60Google Scholar
6Gillison, ML, Lowy, DR. A causal role for human papillomavirus in head and neck cancer. Lancet 2004;363:1488–9Google Scholar
7Kao, SS, Peters, MD, Krishnan, SG, Ooi, EH. Swallowing outcomes following primary surgical resection and primary free flap reconstruction for oral and oropharyngeal squamous cell carcinomas: a systematic review. Laryngoscope 2016;126:1572–80Google Scholar
8Fung, K, Lyden, TH, Lee, J, Urba, SG, Worden, F, Eisbruch, A et al. Voice and swallowing outcomes of an organ-preservation trial for advanced laryngeal cancer. Int J Radiat Oncol Biol Phys 2005;63:1395–9Google Scholar
9van der Molen, L, van Rossum, MA, Burkhead, LM, Smeele, LE, Hilgers, FJ. Functional outcomes and rehabilitation strategies in patients treated with chemoradiotherapy for advanced head and neck cancer: a systematic review. Eur Arch Otorhinolaryngol 2009;266:889–900Google Scholar
10Lohia, S, Rajapurkar, M, Nguyen, SA, Sharma, AK, Gillespie, MB, Day, TA. A comparison of outcomes using intensity-modulated radiation therapy and 3-dimensional conformal radiation therapy in treatment of oropharyngeal cancer. JAMA Otolaryngol Head Neck Surg 2014;140:331–7Google Scholar
11Weinstein, GS, O'Malley, BW Jr, Hockstein, NG. Transoral robotic surgery: supraglottic laryngectomy in a canine model. Laryngoscope 2005;115:1315–19CrossRefGoogle Scholar
12O'Malley, BW Jr, Weinstein, GS, Snyder, W, Hockstein, NG. Transoral robotic surgery (TORS) for base of tongue neoplasms. Laryngoscope 2006;116:1465–72Google Scholar
13Duek, I, Billan, S, Amit, M, Gil, Z. Transoral robotic surgery in the HPV era. Rambam Maimonides Med J 2014;5:e0010CrossRefGoogle ScholarPubMed
14Bernier, J, Domenge, C, Ozsahin, M, Matuszewska, K, Lefebvre, JL, Greiner, RH et al. Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 2004;350:1945–52Google Scholar
15Cooper, JS, Pajak, TF, Forastiere, AA, Jacobs, J, Campbell, BH, Saxman, SB et al. Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 2004;350:1937–44Google Scholar
16Moncrieff, M, Sandilla, J, Clark, J, Clifford, A, Shannon, K, Gao, K et al. Outcomes of primary surgical treatment of T1 and T2 carcinomas of the oropharynx. Laryngoscope 2009;119:307–11CrossRefGoogle ScholarPubMed
17Union for International Cancer Control. TNM Classification of Malignant Tumours, 7th edn. Oxford: Wiley-Blackwell, 2009Google Scholar
18Ang, KK, Harris, J, Wheeler, R, Weber, R, Rosenthal, DI, Nguyen-Tan, PF et al. Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med 2010;363:24–35Google Scholar
19National Health and Medical Research Council. Australian Guidelines to Reduce Health Risks from Drinking Alcohol. Canberra: Commonwealth of Australia, 2009Google Scholar
20El-Naggar, AK, Westra, WH. p16 expression as a surrogate marker for HPV-related oropharyngeal carcinoma: a guide for interpretative relevance and consistency. Head Neck 2012;34:459–61Google Scholar
21Diaz-Molina, JP, Rodrigo, JP, Alvarez-Marcos, C, Blay, P, de la Rua, A, Estrada, E et al. Functional and oncological results of non-surgical vs surgical treatment in squamous cell carcinomas of the oropharynx. Acta Otorrinolaringol Esp 2012;63:348–54Google Scholar
22Garden, AS, Dong, L, Morrison, WH, Stugis, EM, Glisson, BS, Frank, SJ et al. Patterns of disease recurrence following treatment of oropharyngeal cancer with intensity modulated radiation therapy. Int J Radiat Oncol Biol Phys 2013;85:941–7Google Scholar
23Centers for Disease Control and Prevention. HPV-Associated Oropharyngeal Cancer Rates by Race and Ethnicity. In: http://www.cdc.gov/cancer/hpv/statistics/headneck.htm [8 August 2015]Google Scholar
24Zengel, P, Assmann, G, Mollenhauer, M, Jung, A, Sotlar, K, Kirchner, T et al. Cancer of unknown primary originating from oropharyngeal carcinomas are strongly correlated to HPV positivity. Virchows Arch 2012;461:283–90Google Scholar
25Baxi, SS, Pinheiro, LC, Patil, SM, Pfister, DG, Oeffinger, KC, Elkin, EB. Causes of death in long-term survivors of head and neck cancer. Cancer 2014;120:1507–13Google Scholar
26Xu, CC, Biron, VL, Puttagunta, L, Seikaly, H. HPV status and second primary tumours in oropharyngeal squamous cell carcinoma. J Otolaryngol Head Neck Surg 2013;42:36Google Scholar
27Braakhuis, BJ, Tabor, MP, Kummer, JA, Leemans, CR, Brakenhoff, RH. A genetic explanation of Slaughter's concept of field cancerization: evidence and clinical implications. Cancer Res 2003;63:1727–30Google Scholar
28Slaughter, DP, Southwick, HW, Smejkal, W. Field cancerization in oral stratified squamous epithelium; clinical implications of multicentric origin. Cancer 1953;6:963–8Google Scholar