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

Abstract

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.

Perception of Young European Otolaryngologists toward Transoral Robotic Surgery in Head and Neck Oncology and Surgery

“…In our survey, both non-TORS and TORS head and neck surgeons reported similar overall indication outcomes. Precisely, most head and neck surgeon participants considered sleep apnea-related base of tongue surgery and cT1-T2 oropharyngeal and supraglottic cancers as the most appropriate indications of TORS, which match with the most accepted indications in the literature [ 6 , 16 , 17 , 18 , 19 ]. However, notably, European non-TORS and TORS head and neck surgeons appear to be less familiar with fewer common indications, e.g., Sistrunk procedure, laryngocele excision, nasopharyngeal cancer, or thyroid surgery [ 20 , 21 , 22 ].…”

Understanding the Pattern of Oropharyngeal Cancers from North-East Romanian Patients

“…To identify patients at risk of severe evolution, testing for specific biomarkers is necessary, to relate to clinical practice. Recent studies from the USA note the changing therapeutic trends for advanced HPV-positive OPSCC: the percentage of HPV positive patients treated with surgery-based therapy decreasing by half, in the group of patients targeted by the study, during the period 2010-2016 [11]. Howard J et al, from Cambridge, evaluated, in a Cochrane review, the randomized controlled trials regarding the effects of de-intensified adjuvant (chemo)radiotherapy in comparison to standard adjuvant (chemo)radiotherapy in patients with resectable HPV-positive OPSCC, as it is known that HPV-positive OP-SCC patients are often younger and have a significantly improved survival relative to HPV-negative patients.…”