Survival analysis of 287 oropharyngeal squamous cell carcinoma patients in a single institution: a retrospective comparison of two consecutive time intervals with surgical and conservative treatment approaches

Abstract

This study is a retrospective analysis of clinico-pathological data to investigate survival rates of patients with oropharyngeal squamous cell carcinoma (OPSCC) treated with different modalities in a single academic head and neck cancer center in different time intervals. Altogether, 287 patients with OPSCC were included in this comparison. Patients were analysed during two different treatment periods: Group 1 included patients treated mainly with primary surgery ± adjuvant radio(chemo)therapy between 2002 and 2007, while Group 2 included patients treated with organ/function-preservation protocols if indicated. Main outcome measures were overall survival (OS) and recurrence-free survival (RFS). Between 2002 and 2007, early-stage OPSCC showed a 5-year OS of 75% compared to that of 86% between 2008 and 2013. Locally advanced OPSCC showed a 5-year OS of 66% between 2002 and 2007 compared to that of 74% between 2008 and 2013. RFS in early-stage OPSCC was 48% between 2002 and 2007 in contrast to that of 77% between 2008 and 2013. With locally advanced OPSCC, RFS was 55% between 2002 and 2007 compared to that of 56% between 2008 and 2013. These differences were statistically not significant. The OS and RFS remained generally unchanged over the analysed time period. There was no significant difference in the outcomes with regards to HPV status and to their treatment modality.

Oropharyngeal Squamous Cell Carcinoma in 390 Patients: Analysis of Clinical and Histological Criteria Which Significantly Impact Outcome

“…As previously reported, patient age (defined by < 55 and ≥ 55 years) is a significant factor in DFS and OS, but only for p16-positive patients in this cohort of patients (p < 0.0001). These findings are similar to those reported by others, although with different cutoffs amongst studies [6,[29][30][31][32][34][35][36][37][38][39][40][41][42][43][44][45][46]. The majority of patients were white (88.7%), although black patients disproportionately had p16-negative tumors (50%) when compared to white patients (9%).…”

“…Reported 5-year overall survival for p16-positive OPSCC ranges from 60 to 94% for all comers [4,5,[29][30][31][32]. Disease free or progression free survival ranges from 57 to 85% [5,[30][31][32]. In this study, recurrence occurred in 86 (22%) patients with 47 (12%) patients experiencing locoregional disease and 58 (15%) with distant metastases.…”

“…Even though the lack of an inflammatory infiltrate was statistically correlated with a poor prognosis (DFS and OS), it was identified in only 2 patients, and thus may not be an event with sufficient power to warrant such a statement. Reported 5-year overall survival for p16-positive OPSCC ranges from 60 to 94% for all comers [4,5,[29][30][31][32]. Disease free or progression free survival ranges from 57 to 85% [5,[30][31][32].…”

A matched pair analysis of oncological outcomes in human papillomavirus‐negative oropharyngeal squamous cell carcinoma: Transoral surgery versus radiotherapy or concurrent chemoradiation

“…15 Majority of the literature comparing surgical and nonsurgical modalities are retrospective. Münscher et al 16 addressed this question by comparing survival outcomes for patients with OPSCC from different time periods, reflecting the predominance of one treatment approach over the other. Before 2007, the majority of the patients were treated by surgery followed by adjuvant treatment and their outcomes with regard to OS and DFS remained unchanged from the patients treated after 2007 mostly by nonsurgical modalities.…”

HPV's Impact on Head and Neck Cancers: Exploring Prevalence and Prognostic Significance. Doctoral Thesis

“…Moreover, several other studies have indicated a survival advantage in patients who underwent surgical treatment, even when considering their HPV status(Rades et al, 2011;Karatzanis et al, 2012;Kamran et al, 2018). However, the interpretation of results concerning the impact of HPV status on survival has been a subject of controversy(Münscher et al, 2017).Münscher et al conducted a study that suggested the HPV status may not have a significant influence on survival(Münscher et al, 2017). Further research is needed to evaluate the outcome of OPSCC in patients undergoing unilateral or bilateral neck dissection.…”