Oncologic outcomes and patient-reported quality of life in patients with oropharyngeal squamous cell carcinoma treated with definitive transoral robotic surgery versus definitive chemoradiation

Ling, Diane C.; Chapman, Bhavana V.; Kim, J.; Choby, Garret; Kabolizadeh, Peyman; Clump, David A.; Ferris, Robert L.; Kim, S.; Beriwal, Sushil; Heron, Dwight E.; Duvvuri, Umamaheswar

doi:10.1016/j.oraloncology.2016.08.004

Cited by 90 publications

(91 citation statements)

References 22 publications

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“…[6][7][8][9] Moreover, the increasing incidence of HPV-related OPSCC over the last few decades has led to the discovery of a "new" disease with a different epidemiology, which has distinct clinical and pathological features. [14][15][16][17][18][19] In some geographic regions, the relationship between HPV and OPSCC has not been clearly established. However, HPVrelated OPSCC has also been associated with a better tumor response to systemic and local therapies as well as improved disease-free and overall survival compared with patients harboring HPV-unrelated tumors.…”

Section: Introductionmentioning

confidence: 99%

Impact of human papillomavirus status on survival and recurrence in a geographic region with a low prevalence of HPV‐related cancer: A retrospective cohort study

et al. 2019

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Background: Human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) is associated with better tumor-response rates and survival outcomes. However, in some geographic regions, the impact of HPV infection on prognosis remains unclear. The aim of this study was to describe the patterns of recurrence and survival among patients treated for OPSCC in a geographic region with a reported low prevalence of HPV-related OPSCC. Methods: We retrospectively evaluated 215 patients diagnosed with American Joint Committee on Cancer (AJCC) stages I to IV OPSCC who were treated with upfront surgery or radiation therapy with or without chemotherapy in a tertiary Cancer Center in Brazil. The collected data included demographic information, HPV status, tobacco and alcohol consumption, and pathologic and treatment variables. The patterns of recurrence were recorded according to HPV status. Disease-specific survival and recurrencefree survival were calculated. Results: One hundred twenty-seven (59.1%) patients were diagnosed with HPVpositive OPSCC. According to the AJCC eighth edition, 34 (15.8%), 71 (33%), 47 (21.9%), and 60 (27.9%) patients had stage I, II, III, and IV disease, respectively. Surgery was performed in 109 (50.7%) cases, and upfront chemoradiation regimens were provided in 104 (48.4%, P = .69) patients. Overall, the 5-year cancer-specific survival was 73.5% and 68.1% for patients positive and negative to HPV, respectively. Tobacco status was considered the only independent prognostic factor for survival. Furthermore, HPV status was not associated with differences in recurrence rates (P = .68). While all distant relapses were found to be lung metastases in the HPV-negative group, we observed unusual sites of distant metastases in the HPV-positive group. Conclusions: HPV status was not associated with higher rates of survival among the investigated population. Moreover, smoking status was considered the only independent prognostic factor for survival. Furthermore, patients with HPVpositive tumors were more likely than patients with HPV-negative OPSCC to have unusual distant metastases.

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Section: Introductionmentioning

confidence: 99%

Impact of human papillomavirus status on survival and recurrence in a geographic region with a low prevalence of HPV‐related cancer: A retrospective cohort study

et al. 2019

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“…Further, although time to oral diet, diet type, and need for percutaneous endoscopic gastrostomy (PEG) placement have been examined in patients undergoing TORS, no studies have measured swallow functioning in terms of safety and efficiency after TORS procedures. Finally, many of these studies include evaluation of patients after adjuvant therapy and do not assess the functional impact of TORS alone on swallowing …”

Section: Introductionmentioning

confidence: 99%

Prospective instrumental evaluation of swallowing, tongue function, and QOL measures following transoral robotic surgery alone without adjuvant therapy

Lazarus

Ganz

et al. 2018

Head & Neck

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Background Transoral robotic surgery (TORS) has been utilized to deintensify treatment. No studies have measured swallow safety and efficiency, nor assessed the functional impact of TORS alone. Methods This prospective cohort underwent baseline and 1‐month postsurgery assessments including modified barium swallow evaluation, using the Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) rating system, tongue range of motion assessment, the Performance Status Scale (PSS), and quality of life with the MD Anderson Dysphagia Inventory (MDADI). Results All DIGEST safety scores were 0 (normal) at both time points. DIGEST efficiency scores were mildly impaired in 2 of 10 patients postsurgery. PSS scores revealed all patients were on regular diets, were 100% understandable, and were eating in public at both time points. Tongue Range of Motion scores were 100 of 100 at both time points. MDADI scores were not significantly different across time points. Conclusions Careful identification of patients can result in excellent outcomes following TORS. Future studies will examine longer follow‐up of speech, swallowing, and tongue function in patients undergoing TORS surgery.

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“…Moreover, the effects of postoperative RT after TORS and other transoral techniques vary between studies. Although TORS followed by RT only in patients with T1 to T3 N1 to N2c may provide results as good as a UW‐QOL score of 91 out of 100 for the swallowing subdomain after 1 year, it is also possible to find UW‐QOL scores of only 84 of 100 in patients with T1 to T2 N0 to N2b treated with TORS followed by RT, a difference that indicates a significant clinical worsening …”

Section: Discussionmentioning

confidence: 99%

Minimizing adjuvant treatment after transoral robotic surgery through surgical margin revision and exclusion of radiographic extracapsular extension: A Prospective observational cohort study

et al. 2017

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Oncologic outcomes and patient-reported quality of life in patients with oropharyngeal squamous cell carcinoma treated with definitive transoral robotic surgery versus definitive chemoradiation

Cited by 90 publications

References 22 publications

Impact of human papillomavirus status on survival and recurrence in a geographic region with a low prevalence of HPV‐related cancer: A retrospective cohort study

Impact of human papillomavirus status on survival and recurrence in a geographic region with a low prevalence of HPV‐related cancer: A retrospective cohort study

Prospective instrumental evaluation of swallowing, tongue function, and QOL measures following transoral robotic surgery alone without adjuvant therapy

Minimizing adjuvant treatment after transoral robotic surgery through surgical margin revision and exclusion of radiographic extracapsular extension: A Prospective observational cohort study

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