Oncologic and survival outcomes for resectable locally-advanced HPV-related oropharyngeal cancer treated with transoral robotic surgery

Yver, Christina M.; Shimunov, David; Weinstein, Gregory S.; Rajasekaran, Karthik; Cannady, Steven B.; Lukens, John N.; Lin, Alexander; Swisher‐McClure, Samuel; Cohen, Roger B.; Aggarwal, Charu; Bauml, Joshua; Loevner, Laurie A.; Newman, Jason G.; Chalian, Ara A.; Rassekh, Christopher H.; Basu, Devraj; O’Malley, Bert W.; Brody, Robert M.

doi:10.1016/j.oraloncology.2021.105307

Cited by 26 publications

(23 citation statements)

References 33 publications

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“…15 Similarly, a review of 44 observational studies by Yeh et al 16 suggested comparable survival and functionality outcomes in TORS versus intensitymodulated radiation therapy (IMRT); however, it is noted that those selected for transoral robotic surgery were selected for at earlier stages of disease. A recent retrospective study by Brody et al 17 Although our findings with regards to T3 and T4 HPV-negative survival show no statistical significance between radiation-and surgical-based therapy, we have hypothesized, and other studies have demonstrated, that HPV-negative disease treated with upfront surgery may confer survival benefits. For example, the NCDB analysis by Amini et al 18 suggests that multimodality treatment (upfront surgery plus chemoradiation) yields longer overall survival than other treatment options in HPV-negative cases.…”

Section: Overall Survivalcontrasting

confidence: 80%

“…Similarly, a review of 44 observational studies by Yeh et al 16 suggested comparable survival and functionality outcomes in TORS versus intensity‐modulated radiation therapy (IMRT); however, it is noted that those selected for transoral robotic surgery were selected for at earlier stages of disease. A recent retrospective study by Brody et al 17 demonstrated comparable recurrence‐free survival and overall survival between HPV‐positive early T‐stage and late T‐stage oropharyngeal disease treated with up front TORS.…”

Section: Discussionmentioning

confidence: 95%

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Treatment trends for advanced oropharyngeal squamous cell carcinoma in the era of human papillomavirus

et al. 2021

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Background Given recent increase in prevalence of oropharyngeal squamous cell carcinoma (OPSCC) and advances in surgical capabilities, we sought to determine whether a change in frequency of surgery‐based treatment for locally advanced OPSCC has occurred. Methods Patients with T3‐T4b OPSCC in the National Cancer Database diagnosed from 2010 to 2016 were categorized as receiving primary surgery or radiation‐based therapy and stratified by human papillomavirus (HPV) status. Trends in treatment selection and factors associated with treatment type were examined. Results 6566 patients with HPV‐positive were included, of whom 489 (7.45%) received surgery and 4698 patients with HPV‐negative, of whom 362 (7.71%) received surgery. The percentage of patients treated with surgery decreased from 11.8% to 5.9% for HPV‐positive disease and from 9.8% to 6.3% for HPV‐negative disease. Factors associated with surgery included younger age, health insurance, and treatment at academic centers. Conclusions In HPV‐positive and HPV‐negative disease, the percentage of locally advanced OPSCC undergoing surgery‐based therapy has decreased.

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Section: Overall Survivalcontrasting

confidence: 80%

Section: Discussionmentioning

confidence: 95%

Treatment trends for advanced oropharyngeal squamous cell carcinoma in the era of human papillomavirus

et al. 2021

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“…Although the most important aim of BSCC therapy is to radically remove the mass, the surgical scar left on the exposed neck and face is most likely to decrease the postoperative patient satisfaction. The transoral resection approach for oral and oropharyngeal tumors by robot-assisted and endoscopic surgeries is the least invasive method to avoid postoperative facial aesthetics or functional complications [ 5 ]. However, not all clinical institutions have the robot equipment and experience to carry out such an approach.…”

Section: Introductionmentioning

confidence: 99%

Lateral approach is a more aesthetical option for radical resection of BSCC: assessment of its surgical, oncological, functional, and aesthetic outcomes

Wan

Yuan

et al. 2022

BMC Oral Health

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Background The purpose of this study was to introduce a modified lateral approach for combined radical resection of buccal squamous cell carcinoma (BSCC) and evaluate its surgical, oncological, functional, and aesthetic outcomes in comparison with the conventional lower-lip splitting approach. Methods This single-center study retrospectively reviewed 80 patients with BSCC, of which 37 underwent the lateral approach and 43 underwent the conventional approach. Surgical, functional, oncological, and aesthetic evaluations, as well as follow-ups, were recorded and compared. Results Compared to the conventional approach group, the lateral approach group had a longer surgical time (P = 0.000), but there was no significant difference in other surgical and oncological parameters. Moreover, the scar in the head and neck had a significantly discreet appearance in the lateral approach group, whose satisfaction was better than those in the conventional approach group (P = 0.000). Other oral function parameters, postoperative mouth-opening, and 3-year survival rate were not significantly different between the two groups. Conclusion The lateral approach could provide superior aesthetic results while maintaining equal surgical, functional, and oncological outcomes compared to the conventional approach for radical resection of BSCC.

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“…HPV-related OPSCC generally has a good prognosis with a 5-year overall survival rate of 80%-91% and a recurrence-free survival rate of 78%-90%. [4][5][6][7][8][9] The majority of recurrences, approximately 66%-80%, occur within the first two years after treatment and are locoregional (54%). [10][11][12][13] Surgical salvage of recurrent disease is associated with better overall survival.…”

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confidence: 99%

Clinical Uncertainties of Circulating Tumor DNA in Human Papillomavirus–Related Oropharyngeal Squamous Cell Carcinoma in the Absence of National Comprehensive Cancer Network Guidelines

Xie

Kut

Quon

et al. 2023

JCO

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Oncologic and survival outcomes for resectable locally-advanced HPV-related oropharyngeal cancer treated with transoral robotic surgery

Cited by 26 publications

References 33 publications

Treatment trends for advanced oropharyngeal squamous cell carcinoma in the era of human papillomavirus

Treatment trends for advanced oropharyngeal squamous cell carcinoma in the era of human papillomavirus

Lateral approach is a more aesthetical option for radical resection of BSCC: assessment of its surgical, oncological, functional, and aesthetic outcomes

Clinical Uncertainties of Circulating Tumor DNA in Human Papillomavirus–Related Oropharyngeal Squamous Cell Carcinoma in the Absence of National Comprehensive Cancer Network Guidelines

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