Transoral robotic surgery and adjuvant therapy for oropharyngeal carcinomas and the influence of p16INK4a on treatment outcomes

Objectives/Hypothesis: To determine the prognostic influence of p16INK4a immunohistochemistry on the survival of resectable oropharyngeal carcinomas (OPSCC). Study Design: Retrospective pathologic evaluation of a prospective single-arm cohort study at a tertiary referral center. Methods: There were 48 patients with resectable OPSCC who consented for transoral robotic surgery (TORS) and banked tissue specimen for assessment. TORS was with or without adjuvant radiation or chemoradiation. Main outcome measures were p16INK4a status, human papillomavirus status, local-regional disease control, and overall, disease-specific, and disease-free survival. Results: p16INK4a and HPV positivity were identified in 73% and 74% of patients respectively. With a median follow-up of 38.8 months (2.563.3 months), only one local-regional relapse has occurred in both the p16INK4a-positive and p16INK4a-negative cohorts. No disease-specific, disease-free, and overall survival differences were observed between p16INK4a-positive and p16INK4a-negative patients (P = .446, P = .277, P = .643, respectively). Conclusions: p16INK4a was not prognostic in resectable OPSCC when treated with an initial TORS approach. Laryngoscope, 2013