4.6 Article

Upfront surgery or definitive radiotherapy for p16+oropharyngeal cancer. A GETTEC multicentric study

Journal

EJSO
Volume 47, Issue 6, Pages 1389-1397

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.ejso.2020.12.011

Keywords

Oropharynx; Cancer; Human papilloma virus; Surgery; Radiotherapy; Survival

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This study aimed to evaluate the impact of initial therapeutic strategy on oncologic outcomes in patients with HPV-positive oropharyngeal squamous cell carcinoma. The results showed that surgical strategy demonstrated significant differences in disease-specific and recurrence-free survival compared to non-surgical strategy, especially after multivariate analysis.
Background: The aim of this study was to assess the impact of the initial therapeutic strategy on oncologic outcomes in patients with HPV-positive OPSCC. Methods: All p16-positive OPSCCs treated from 2009 to 2014 in 7 centers were retrospectively included and classified according to the therapeutic strategy: surgical strategy (surgery +/- adjuvant radiotherapy and chemotherapy) vs. non-surgical strategy (definitive radiotherapy +/- chemotherapy). Univariate, multivariate propensity score matching analyses were performed to compare overall (OS), diseasespecific (DSS) and recurrence-free survival (RFS). Results: 382 patients were included (surgical group: 144; non-surgical group: 238). Five-year OS, DSS and RFS were 89.2, 96.8 and 83.9% in the surgical group and 84.2, 87.1 and 70.4% in the non-surgical group, respectively. These differences were statistically significant for DSS and RFS after multivariate analysis, but only for RFS after propensity score matching analysis.

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