Transoral Surgery Versus Radiotherapy as Primary Treatment for HPV-Related Oropharyngeal Cancer in the Elderly.

IF 2.3 3区医学 Q1 OTORHINOLARYNGOLOGY Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2025-02-07 DOI:10.1002/hed.28097

Andrea Costantino, Bruce Haughey, Jianbin Zhu, Uthman Alamoudi, J Scott Magnuson

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引用次数: 0

Abstract

Background: This study compares the oncological outcomes of primary transoral surgery (TOS) and primary radiotherapy (RT) in elderly patients with HPV-related oropharyngeal squamous cell carcinoma (OPSCC).

Methods: This retrospective cohort study included patients with cT1-2 HPV-related OPSCC from the National Cancer Database (NCDB).

Results: A total of 2566 patients were included, with 73.9% receiving primary RT and 22.3% undergoing primary TOS. Subgroup analysis showed a higher 5-year overall survival (OS) rate for primary TOS (81.6%; 95% CI: 79.6%-83.6%) compared to primary RT (70.7%; 95% CI: 68.3%-73.1%), with an adjusted hazard ratio (HR) of 0.64 (95% CI: 0.50-0.81; p < 0.001) after propensity score matching. Notably, only (13.6%) of patients diagnosed in 2020 underwent primary TOS, with a significant decline over the study period.

Conclusions: This study suggests that primary TOS may offer better survival outcomes for elderly patients with HPV-related OPSCC compared to primary RT.

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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.