Neoadjuvant chemotherapy followed by transoral robotic surgery versus upfront surgery for locoregionally advanced oropharyngeal carcinoma: A propensity score matched analysis.

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2024-08-01 DOI:10.1002/hed.27904

Claudio Sampieri, Eleonora Cioccoloni, Andrea Costantino, Dahee Kim, Kyuin Lee, Giuseppe Meccariello, Giovanni Cammaroto, Claudio Vicini, Se-Heon Kim

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Abstract

Background: Transoral robotic surgery (TORS) performed after neoadjuvant chemotherapy (NAC) is a promising treatment for advanced-stage oropharyngeal carcinoma (OPSCC) able to reduce the adjuvant therapy administration rate.

Methods: A retrospective bi-centric study was conducted to analyze NAC + TORS versus upfront TORS patients. A 1:1 propensity score matching was used to compare the two groups.

Results: Among the 300 patients with stage III-IV OPSCC, 204 patients were matched for comparing NAC + TORS versus upfront TORS. Between the two groups, no significant difference was observed in recurrences and in survival for RFS, OS, and DSS. In the NAC + TORS p16-positive population, adjuvant therapy could be spared in 51% versus 16% in the upfront surgery cohort (p < 0.001) due to the lower frequency of pathological risk factors after NAC.

Conclusions: NAC followed by TORS for locoregionally advanced OPSCC demonstrated to achieve non-inferior survival outcomes to upfront surgery, while in the p16-positive population allowed to significantly spare adjuvant therapy.

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局部晚期口咽癌的新辅助化疗后经口腔机器人手术与前期手术：倾向评分匹配分析。

背景：在新辅助化疗（NAC）后进行经口机器人手术（TORS）是一种治疗晚期口咽癌（OPSCC）的有效方法，可降低辅助治疗的用药率：一项回顾性双中心研究分析了 NAC + TORS 与先期 TORS 患者。结果：在 300 例 III- 期癌症患者中，NAC + TORS 与前期 TORS 患者的比例为 1:1：在 300 名 III-IV 期 OPSCC 患者中，有 204 名患者进行了 NAC + TORS 与前期 TORS 的匹配比较。两组患者的复发率以及 RFS、OS 和 DSS 的生存率均无明显差异。在 NAC + TORS p16 阳性人群中，有 51% 的人可以免于辅助治疗，而在前期手术人群中，只有 16% 的人可以免于辅助治疗（PNAC+TORS治疗局部晚期OPSCC的生存率不低于前期手术，而在p16阳性人群中，可以显著减少辅助治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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