Transoral robotic surgery for oropharyngeal squamous cell carcinoma in the era of human papillomavirus

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7 Citations (Scopus)

Abstract

Background: The emergence of transoral robotic surgery (TORS) ignited the debate between surgical and nonsurgical strategies on oropharyngeal squamous cell carcinoma (SCC) management; a question further complicated by human papillomavirus (HPV). We evaluated the survival by treatment strategy independently in HPV-related and HPV-nonrelated oropharyngeal SCC. Methods: The National Cancer Database was queried for patients with oropharyngeal SCC with known HPV status who underwent primary TORS or primary radiotherapy. The overall survival (OS) was compared by treatment strategy, including propensity matching to control for confounders. Results: Of 1873 patients, 73% were HPV-positive and 30% were treated with TORS. The propensity-matched patients with HPV-positive disease displayed no significant difference in 3-year survival; 95% versus 91% (P=.116) for the TORS versus primary radiotherapy. In the HPV-negative cohort, TORS was associated with superior survival; 84% versus 66% (P=.01). Conclusion: The TORS-based approach was associated with superior survival in patients with HPV-negative oropharyngeal SCC; similar difference was not observed in patients with HPV-positive disease.

Original languageEnglish (US)
JournalHead and Neck
DOIs
StateAccepted/In press - Jan 1 2017

Fingerprint

Robotics
Squamous Cell Carcinoma
Survival
Radiotherapy
Databases
Therapeutics

Keywords

  • Human papillomavirus
  • Oropharyngeal cancer
  • Radiotherapy
  • Transoral robotic surgery

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

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title = "Transoral robotic surgery for oropharyngeal squamous cell carcinoma in the era of human papillomavirus",
abstract = "Background: The emergence of transoral robotic surgery (TORS) ignited the debate between surgical and nonsurgical strategies on oropharyngeal squamous cell carcinoma (SCC) management; a question further complicated by human papillomavirus (HPV). We evaluated the survival by treatment strategy independently in HPV-related and HPV-nonrelated oropharyngeal SCC. Methods: The National Cancer Database was queried for patients with oropharyngeal SCC with known HPV status who underwent primary TORS or primary radiotherapy. The overall survival (OS) was compared by treatment strategy, including propensity matching to control for confounders. Results: Of 1873 patients, 73{\%} were HPV-positive and 30{\%} were treated with TORS. The propensity-matched patients with HPV-positive disease displayed no significant difference in 3-year survival; 95{\%} versus 91{\%} (P=.116) for the TORS versus primary radiotherapy. In the HPV-negative cohort, TORS was associated with superior survival; 84{\%} versus 66{\%} (P=.01). Conclusion: The TORS-based approach was associated with superior survival in patients with HPV-negative oropharyngeal SCC; similar difference was not observed in patients with HPV-positive disease.",
keywords = "Human papillomavirus, Oropharyngeal cancer, Radiotherapy, Transoral robotic surgery",
author = "Omar Mahmoud and Kim Sung and Francisco Civantos and Giovana Thomas and Samuels, {Michael A}",
year = "2017",
month = "1",
day = "1",
doi = "10.1002/hed.25036",
language = "English (US)",
journal = "Head and Neck",
issn = "1043-3074",
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TY - JOUR

T1 - Transoral robotic surgery for oropharyngeal squamous cell carcinoma in the era of human papillomavirus

AU - Mahmoud, Omar

AU - Sung, Kim

AU - Civantos, Francisco

AU - Thomas, Giovana

AU - Samuels, Michael A

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background: The emergence of transoral robotic surgery (TORS) ignited the debate between surgical and nonsurgical strategies on oropharyngeal squamous cell carcinoma (SCC) management; a question further complicated by human papillomavirus (HPV). We evaluated the survival by treatment strategy independently in HPV-related and HPV-nonrelated oropharyngeal SCC. Methods: The National Cancer Database was queried for patients with oropharyngeal SCC with known HPV status who underwent primary TORS or primary radiotherapy. The overall survival (OS) was compared by treatment strategy, including propensity matching to control for confounders. Results: Of 1873 patients, 73% were HPV-positive and 30% were treated with TORS. The propensity-matched patients with HPV-positive disease displayed no significant difference in 3-year survival; 95% versus 91% (P=.116) for the TORS versus primary radiotherapy. In the HPV-negative cohort, TORS was associated with superior survival; 84% versus 66% (P=.01). Conclusion: The TORS-based approach was associated with superior survival in patients with HPV-negative oropharyngeal SCC; similar difference was not observed in patients with HPV-positive disease.

AB - Background: The emergence of transoral robotic surgery (TORS) ignited the debate between surgical and nonsurgical strategies on oropharyngeal squamous cell carcinoma (SCC) management; a question further complicated by human papillomavirus (HPV). We evaluated the survival by treatment strategy independently in HPV-related and HPV-nonrelated oropharyngeal SCC. Methods: The National Cancer Database was queried for patients with oropharyngeal SCC with known HPV status who underwent primary TORS or primary radiotherapy. The overall survival (OS) was compared by treatment strategy, including propensity matching to control for confounders. Results: Of 1873 patients, 73% were HPV-positive and 30% were treated with TORS. The propensity-matched patients with HPV-positive disease displayed no significant difference in 3-year survival; 95% versus 91% (P=.116) for the TORS versus primary radiotherapy. In the HPV-negative cohort, TORS was associated with superior survival; 84% versus 66% (P=.01). Conclusion: The TORS-based approach was associated with superior survival in patients with HPV-negative oropharyngeal SCC; similar difference was not observed in patients with HPV-positive disease.

KW - Human papillomavirus

KW - Oropharyngeal cancer

KW - Radiotherapy

KW - Transoral robotic surgery

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