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

IF 2.2 3区医学 Q1 OTORHINOLARYNGOLOGY Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2024-08-01 DOI:10.1002/hed.27904

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

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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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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.