Madeleine Ausburn, Justin M Pyne, Andrew T Day, Natalia Hajnas, Dominic Moon, Larry Leonard Myers, David Jonathan Sher, John M Truelson, Brittny Tillman, Baran Sumer
{"title":"Margin Status and Recurrence in Surgically Treated Patients With HPV+ Oropharyngeal Cancer.","authors":"Madeleine Ausburn, Justin M Pyne, Andrew T Day, Natalia Hajnas, Dominic Moon, Larry Leonard Myers, David Jonathan Sher, John M Truelson, Brittny Tillman, Baran Sumer","doi":"10.1002/lary.32091","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The optimal margins for surgically treated human papilloma virus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) remain undefined. We evaluated the impact of surgical margins on progression-free survival (PFS) in patients with HPV+ OPSCC treated with primary transoral robotic surgery (TORS).</p><p><strong>Methods: </strong>Patients undergoing primary TORS from May 2012 to December 2021 for intermediate-risk (T1-T2, resected to clear (≥ 3 mm) or close margins (< 3 mm), and N1-N2) HPV+ OPSCC were included. Survival outcomes were reviewed, and overall and PFS at 3 years posttreatment were determined using Kaplan-Meier analysis.</p><p><strong>Results: </strong>A total of 69 subjects met inclusion criteria. At a median follow-up of 47 months, overall survival (OS) was 100%, and the PFS was 88.9% for the entire subject group. Among subjects not receiving adjunctive radiotherapy (RT), those with close margins had an OS of 100% and a PFS of 100% (median follow-up 47 months). Subjects with clear margins had an OS probability of 100% and a PFS probability of 100% (median follow-up 47 months).</p><p><strong>Conclusion: </strong>In subjects undergoing TORS for HPV+ OPSCC, clear margins did not confer a significant OS or PFS survival advantage compared to those with close margins, even when adjuvant therapy was omitted.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laryngoscope","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/lary.32091","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The optimal margins for surgically treated human papilloma virus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) remain undefined. We evaluated the impact of surgical margins on progression-free survival (PFS) in patients with HPV+ OPSCC treated with primary transoral robotic surgery (TORS).
Methods: Patients undergoing primary TORS from May 2012 to December 2021 for intermediate-risk (T1-T2, resected to clear (≥ 3 mm) or close margins (< 3 mm), and N1-N2) HPV+ OPSCC were included. Survival outcomes were reviewed, and overall and PFS at 3 years posttreatment were determined using Kaplan-Meier analysis.
Results: A total of 69 subjects met inclusion criteria. At a median follow-up of 47 months, overall survival (OS) was 100%, and the PFS was 88.9% for the entire subject group. Among subjects not receiving adjunctive radiotherapy (RT), those with close margins had an OS of 100% and a PFS of 100% (median follow-up 47 months). Subjects with clear margins had an OS probability of 100% and a PFS probability of 100% (median follow-up 47 months).
Conclusion: In subjects undergoing TORS for HPV+ OPSCC, clear margins did not confer a significant OS or PFS survival advantage compared to those with close margins, even when adjuvant therapy was omitted.
期刊介绍:
The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope.
• Broncho-esophagology
• Communicative disorders
• Head and neck surgery
• Plastic and reconstructive facial surgery
• Oncology
• Speech and hearing defects