Abstract Objective To describe the clinical predictors of survival, disease control, and functional outcomes in patients with HPV‐negative oropharyngeal squamous cell carcinoma (OPSCC) who underwent primary transoral surgery (TOS). Study Design Retrospective cohort study. Setting The study was conducted in a high‐volume, NCI‐designated tertiary care setting. Methods Patients with HPV‐negative OPSCC who underwent primary definitive TOS with risk‐adapted adjuvant therapy (1998‐2020) were identified. The primary outcome measures were overall survival (OS) and recurrence‐free survival (RFS). Secondary outcomes included postoperative gastrostomy tube (G‐tube) rates, tracheostomy rates, and functional outcome swallowing scale (FOSS) scores. Results A total of 89 patients were treated with TOS for HPV‐negative OPSCC. The majority of patients presented with late‐stage disease (stage III/IV, 73%); 79% with early tumor stage (T1/T2) and 71% with positive nodal disease. Three‐year estimates for OS and RFS for the entire cohort were 67.2% and 63.3% respectively. Advanced tumor stage predicted worsened OS HR 3.23, 95% CI 1.75‐5.95 and RFS HR 2.38, 95% CI 1.13‐5.01 on univariable analysis. Stage III/IV disease was associated with worsened OS HR 2.16, 95% CI 1.01‐4.63, but not RFS. Thirty‐two patients (36%) recurred during the follow‐up period; 19 (21%) failed locoregionally, and 13 (15%) failed distantly. Five patients (6%) were G‐tube dependent and 3 patients (3%) were tracheostomy dependent at 1‐year. Conclusion Transoral surgery may be considered as a primary treatment in HPV‐negative OPSCC with acceptable oncologic outcomes and the potential for improved functional outcomes.
Chang et al. (Thu,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: