Matched-Pair Analysis in Patients with Advanced Oropharyngeal Cancer: Surgery versus Concurrent Chemoradiotherapy

Abstract

Objective: The current study aimed to compare the therapeutic outcomes of surgery with those of chemoradiation for patients with advanced oropharyngeal cancer (OPC). Methods: The data for 523 patients with previously untreated OPC were obtained from 12 institutions belonging to the Head and Neck Cancer Study Group in the Japan Clinical Oncology Group from April 2005 to March 2007. In this study, we matched a group of patients who underwent surgery with a second group treated with chemoradiation according to age, gender, subsite, and T and N classification, and analyzed the overall survival, progression-free survival, local control and swallowing function. Results: The final matched-pair analysis included 186 patients. The 5-year overall survival, progression-free survival and local control rates were 69.8 and 71.4% (p = 0.762), 51.0 and 54.4% (p = 0.531), and 75.2 and 80.3% (p = 0.399), respectively, in patients treated with surgery and those treated with chemoradiation. Swallowing function in patients treated with chemoradiation was significantly better than that in patients treated with surgery (p = 0.015). Conclusion: Although this study was not randomized, this matched-pair analysis of patients treated with surgery or chemoradiation showed that chemoradiation is as effective as surgery in the treatment of OPC.

Role of primary surgery in the treatment of advanced oropharyngeal cancer

“…23,27,28,44 Our cohort treated with single modality had a reduced DSS when compared with patients who received multimodality protocols (Figure 3), as reported by other studies. 5,10,11,16,18,20 Patients treated with S1RT/CRT and CRT had a 5-year DSS of 80.5% and 55.8%, which are well within the range of previously reported figures of 79.5% to 63.9% for surgery and 84.2% to 27% for CRT protocols. 4,5,10,11,18 Moreover, the multivariate Cox regression analyses showed that increasing ECOG score, smoking, p16 status, and higher TNM stage were significant determinants of survival.…”

Association of impaired renal function and poor prognosis in oropharyngeal squamous cell carcinoma

“…In this study, we analyzed whether renal function is a prognostic factor in oropharyngeal SCC using data obtained from 12 institutions across Japan …”

“…[4][5][6][7] In this study, we analyzed whether renal function is a prognostic factor in oropharyngeal SCC using data obtained from 12 institutions across Japan. [8][9][10] gathered from 12 institutions belonging to the Head and Neck Cancer Study Group in the Japan Clinical Oncology Group. Overall, 37 patients who received palliative therapy, 16 patients with non-SCC, and 10 patients for whom complete data could not be obtained were excluded from further analysis, and the data for the remaining 460 patients were analyzed retrospectively.…”

Treatments for locally advanced oropharyngeal cancer: A systematic review of clinical effectiveness and cost-effectiveness.

“…Fourteen non-randomized studies were identified regarding the comparative clinical effectiveness of primary surgery versus primary CRT for locally advanced oropharyngeal cancer. Six studies [20][21][22][23][24][25] were prospective, seven studies [26][27][28][29][30][31][32] were retrospective, and one study 33 was cross-sectional. Specifically, four studies [20][21][22][23] were prospective cohort studies, one study 25 was a prospective case series compared with a historical cohort, one study 24 was a prospective observational pre-and post-study compared with a historical cohort, seven studies [26][27][28][29][30][31][32] were retrospective cohort studies.…”

“…Of the 14 studies, three studies 21,25,33 were conducted in Italy, two studies 20,22 were conducted in Canada, three studies 23,26,27 were conducted in the United States, one study 24 was conducted in the United Kingdom, one study 28 was conducted in Australia, one study 29 was conducted in Japan, two studies 30,32 were conducted in South Korea, and one study 31 was conducted in Taiwan.…”