Outcome of patients with early T1 and T2 squamous cell carcinoma of the base of tongue managed by conventional surgery with adjuvant postoperative radiation

Abstract

T classification and ECE are independent predictors of outcome for BOT SCC. Patients with cT1/T2 tumors had excellent outcome and may be suitable for transoral robotic or endoscopic surgical procedures.

Detailed Analysis of Clinicopathologic Factors Demonstrate Distinct Difference in Outcome and Prognostic Factors Between Surgically Treated HPV-Positive and Negative Oropharyngeal Cancer

“…These data support the notion that HPV-associated disease predominates in subsites with mucosa-associated lymphoid tissue and should be considered differently, rather than defining oropharynx as a purely anatomic site, which includes the soft palate and lateral and posterior pharyngeal walls. 16,17 In agreement with previous reports, patients with p16-positive tumors were younger, nonsmokers, had lower T-stage, and had higher likelihood for nodal metastases. 2,22 Interestingly, these tumors tend to be more common in males ( p = .012), providing a strong basis for advocating HPV vaccination in boys, as well as girls.…”

“…12,28 Previous studies have shown this approach can spare unnecessary radiation in 20–40 % of well-selected cohorts. 16 Secondly, the availability of a surgical specimen allows meticulous identification of other high-risk features that may guide adjuvant treatment. However, there is a long list of putative high-risk features, and the relative contribution of each of these has not been previously established through multivariable analysis.…”

“…16,17 Surgical staging can be used to determine subsequent adjuvant therapy or avoid it altogether. 18 However, in order for this concept to work, 2 further steps have to take place.…”

The impact of transoral robotic surgery on the overall treatment of oropharyngeal cancer patients

“…Therefore, many patients receive triple‐modality therapy, rather than single‐ or dual‐modality therapy, with a possible increase in associated complications, notably swallowing issues and the need for gastrostomy tubes . Similar rates of OS, DSS, and adjuvant therapy administration have been reported with TORS therapy as well, which are generally better than recently reported series with conventional surgical management followed by adjuvant therapy …”

“…18 Similar rates of OS, DSS, and adjuvant therapy administration have been reported with TORS therapy as well, [21][22][23][24] which are generally better than recently reported series with conventional surgical management followed by adjuvant therapy. 25,26 All oncologists-surgical, medical, or radiationseek to cure patients of their cancer. Using the most simplistic classification, we can induce three possible outcomes: proper treatment, undertreatment, and overtreatment.…”