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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: stephen.kao@sa.gov.au
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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.

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