Upfront surgery or definitive radiotherapy for p16+ oropharyngeal cancer. A GETTEC multicentric study.

Aged Antineoplastic Agents, Immunological / therapeutic use Cetuximab / therapeutic use Chemoradiotherapy, Adjuvant Cisplatin / therapeutic use Cyclin-Dependent Kinase Inhibitor p16 / metabolism Female Humans Induction Chemotherapy Male Middle Aged Neoplasm Recurrence, Local / surgery Neoplasm Staging Oropharyngeal Neoplasms / metabolism Papillomavirus Infections / complications Radiotherapy, Adjuvant Retrospective Studies Survival Rate

Cancer Human papilloma virus Oropharynx Radiotherapy Surgery Survival

Journal

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

ISSN: 1532-2157

Titre abrégé: Eur J Surg Oncol

Pays: England

ID NLM: 8504356

Informations de publication

Date de publication:
06 2021

Historique:

received: 28 09 2020

revised: 25 11 2020

accepted: 15 12 2020

pubmed: 5 1 2021

medline: 12 10 2021

entrez: 4 1 2021

Statut: ppublish

Résumé

The aim of this study was to assess the impact of the initial therapeutic strategy on oncologic outcomes in patients with HPV-positive OPSCC. All p16-positive OPSCCs treated from 2009 to 2014 in 7 centers were retrospectively included and classified according to the therapeutic strategy: surgical strategy (surgery ± adjuvant radiotherapy and chemotherapy) vs. non-surgical strategy (definitive radiotherapy ± chemotherapy). Univariate, multivariate propensity score matching analyses were performed to compare overall (OS), disease-specific (DSS) and recurrence-free survival (RFS). 382 patients were included (surgical group: 144; non-surgical group: 238). Five-year OS, DSS and RFS were 89.2, 96.8 and 83.9% in the surgical group and 84.2, 87.1 and 70.4% in the non-surgical group, respectively. These differences were statistically significant for DSS and RFS after multivariate analysis, but only for RFS after propensity score matching analysis. In p16+ OPSCC patients, upfront surgery results in higher RFS than definitive radiotherapy ± chemotherapy but does not impact OS.

Sections du résumé

BACKGROUND

The aim of this study was to assess the impact of the initial therapeutic strategy on oncologic outcomes in patients with HPV-positive OPSCC.

METHODS

All p16-positive OPSCCs treated from 2009 to 2014 in 7 centers were retrospectively included and classified according to the therapeutic strategy: surgical strategy (surgery ± adjuvant radiotherapy and chemotherapy) vs. non-surgical strategy (definitive radiotherapy ± chemotherapy). Univariate, multivariate propensity score matching analyses were performed to compare overall (OS), disease-specific (DSS) and recurrence-free survival (RFS).

RESULTS

382 patients were included (surgical group: 144; non-surgical group: 238). Five-year OS, DSS and RFS were 89.2, 96.8 and 83.9% in the surgical group and 84.2, 87.1 and 70.4% in the non-surgical group, respectively. These differences were statistically significant for DSS and RFS after multivariate analysis, but only for RFS after propensity score matching analysis.

CONCLUSION

In p16+ OPSCC patients, upfront surgery results in higher RFS than definitive radiotherapy ± chemotherapy but does not impact OS.

Identifiants

DOI: 10.1016/j.ejso.2020.12.011 PMID: 33390333

pubmed: 33390333

pii: S0748-7983(20)31230-0

doi: 10.1016/j.ejso.2020.12.011

pii:

doi:

Substances chimiques

Antineoplastic Agents, Immunological 0

CDKN2A protein, human 0

Cyclin-Dependent Kinase Inhibitor p16 0

Cetuximab PQX0D8J21J

Cisplatin Q20Q21Q62J

Types de publication

Comparative Study Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

Pagination

1389-1397