TRANSORAL LASER MICROSURGERY AS PRIMARY TREATMENT FOR ADVANCED-STAGE OROPHARYNGEAL CANCER: A UNITED STATES MULTICENTER STUDY

Background. Nonsurgical modalities are sometimes advocated as the standard of care for advanced oropharyngeal tumors. Oncologic and functional results have been modest. The aim of our study was to evaluate outcomes of a minimally invasive approach, using transoral laser microsurgery (TLM) as the primary treatment for advanced oropharyngeal carcinoma. Methods. A prospectively assembled database of 204 patients with American Joint Committee on Cancer (AJCC) stages III and IV tonsil or tongue base cancer, treated primarily with TLM during 1996-2006 at 3 centers with minimum 2-year follow-up was analyzed. Survival, locoregional control, and swallowing status were recorded. Results. Mean follow-up was 49 months and 79.4% of patients were alive. Three-year overall survival, disease-specific survival, and disease-free survival were 86%, 88%, and 82%, respectively. Local control was 97%, and 87% of patients had normal swallowing or episodic dysphagia. Conclusions. TLM as a primary treatment for advanced oropharyngeal malignancy confers excellent survival and swallowing proficiency. (C) 2011 Wiley Periodicals, Inc. Head Neck 33: 1683-1694, 2011