Transoral robotic surgery with neck dissection versus nonsurgical treatment in stage I and II human papillomavirus-negative oropharyngeal cancer

被引：6
|
作者：
Bollig, Craig A. [1 ]
Morris, Brian [2 ]
Stubbs, Vanessa C. [1 ]
机构：
[1] Rutgers Robert Wood Johnson Med Sch, Dept Otolaryngol Head & Neck Surg, New Brunswick, NJ USA
[2] Penn State Coll Med, Dept Surg, Hershey, PA USA
来源：
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK | 2022年 / 44卷 / 07期
关键词：
human papillomavirus-negative; minimally invasive surgery; oropharyngeal cancer; radiation therapy; transoral robotic surgery; SQUAMOUS-CELL CARCINOMA; QUALITY-OF-LIFE; SURVIVAL; OUTCOMES; HEAD; RADIOTHERAPY; THERAPY; TRENDS; IMPACT; TORS;
D O I：
10.1002/hed.27045
中图分类号：
R76 [耳鼻咽喉科学];
学科分类号：
100213 ;
摘要：
Background Surgery + adjuvant therapy was shown to have improved overall survival (OS) versus nonsurgical treatment in T1-T2N1-N2b human papillomavirus (HPV)-negative oropharyngeal cancer (OPC). Our objective was to compare OS in transoral robotic surgery (TORS) with neck dissection versus nonsurgical treatment for T1-T2N0 HPV-negative OPC. Methods Patients with T1-T2N0 HPV-negative OPC were identified in the National Cancer Database. OS was compared between groups: (1) TORS with neck dissection +/- adjuvant therapy, (2) primary radiotherapy (>60 Gy) +/- chemotherapy using Kaplan-Meier and multivariable Cox proportional hazards models. Results There were 665 (78.4%) patients treated nonsurgically and 183 (21.6%) patients in the TORS group. Adjusting for age, comorbidity score, facility type, tumor subsite, and tumor stage, primary nonsurgical treatment was associated with worse OS (hazard ratio: 1.90, 95% CI: 1.34-2.69). Conclusion For T1-T2N0 HPV-negative OPC, TORS with neck dissection may be associated with a survival benefit over nonsurgical treatment.
引用
收藏
页码：1545 / 1553
页数：9
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