Upfront surgery or definitive radiotherapy for patients with p16-negative oropharyngeal squamous cell carcinoma. A GETTEC multicentric study.

Abstract

INTRODUCTION:

Therapeutic management of oropharyngeal squamous cell carcinomas (OPSCC) is still debated. Since the role of HPV was demonstrated, few studies have focused on HPV-negative OPSCC. The aim of our study was to assess the impact of therapeutic strategy (surgical vs. non-surgical) on oncologic outcomes in patients with HPV-negative OPSCC.

MATERIAL AND METHOD:

All p16-negative OPSCCs treated from 2009 to 2014 in 7 tertiary-care centers were included in this retrospective study and were classified according to the therapeutic strategy: surgical strategy (surgery ± adjuvant radiotherapy and chemotherapy) vs. non-surgical strategy (definitive radiotherapy ± chemotherapy). Patients not eligible for surgery (unresectable tumor, poor general-health status) were excluded. Univariate, multivariate and propensity score matching analyses were performed to compare overall (OS), disease-specific (DSS) and recurrence-free survival (RFS).

RESULTS:

Four hundred seventy-four (474) patients were included in the study (surgical group: 196; non-surgical group: 278). Five-year OS, DSS and RFS were 76.5, 81.3 and 61.3%, respectively, in the surgical group and 49.9, 61.8 and 43.4%, respectively, in the non-surgical group. The favorable impact of primary surgical treatment on oncologic outcomes was statistically significant after multivariate analysis. This effect was more marked for locally-advanced than for early-stage tumors. Propensity score matching analysis confirmed the prognostic impact of primary surgical treatment for RFS.

CONCLUSION:

Therapeutic strategy is an independent prognostic factor in patients with p16-negative OPSCC and primary surgical treatment is associated with improved OS, DSS and RFS. These results suggest that surgical strategy is a reliable option for advanced stage OPSCC.

• Authors: Dorian Culié, Julien Viotti, Anouchka Modesto, Renaud Schiappa, Emmanuel Chamorey, Olivier Dassonville, Gilles Poissonnet, Bruno Guelfucci, Alain Bizeau, Sebastien Vergez, Agnes Dupret-Bories, Renaud Garrel, Nicolas Fakhry, Laure Santini, Benjamin Lallemant, Guillaume Chambon, Anne Sudaka, Frederic Peyrade, Esma Saada-Bouzid, Karen Benezery, Florence Jourdan-Soulier, Françoise Chapel, Anne Sophie Ramay, Pascal Roger, Thibault Galissier, Valérie Coste, Aicha Ben Lakdar, Joanne Guerlain, Stephane Temam, Haitham Mirghani, Phillipe Gorphe, Alexandre Bozec
• Journal: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology (Eur J Surg Oncol) Vol. 47 Issue 2 Pg. 367-374 (02 2021) ISSN: 1532-2157 [Electronic] England
• PMID: 33004271 (Publication Type: Journal Article, Multicenter Study)
• Copyright: Copyright © 2020 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Chemical References

• Antibodies, Viral

Topics

• Antibodies, Viral (analysis)
• Carcinoma, Squamous Cell (diagnosis, therapy)
• Female
• Follow-Up Studies
• Human papillomavirus 16 (immunology)
• Humans
• Male
• Middle Aged
• Oropharyngeal Neoplasms (diagnosis, therapy)
• Otorhinolaryngologic Surgical Procedures (methods)
• Prognosis
• Radiotherapy, Adjuvant
• Retrospective Studies