Transoral laser microsurgery for oropharyngeal squamous cell carcinoma: A paradigm shift in therapeutic approach



Wilkie, MD, Upile, NS, Lau, AS ORCID: 0000-0002-6489-204X, Williams, SP, Sheard, J, Helliwell, TR ORCID: 0000-0003-2112-4128, Robinson, M, Rodrigues, J, Beemireddy, K, Lewis Jones, H
et al (show 9 more authors) (2016) Transoral laser microsurgery for oropharyngeal squamous cell carcinoma: A paradigm shift in therapeutic approach. Head and Neck, 38 (8). pp. 1263-1270.

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Abstract

Background: The contemporary treatment of oropharyngeal squamous cell carcinoma (SCC) is an area of debate. We report outcomes of a minimally invasive approach involving transoral laser microsurgery (TLM). Methods: A consecutive series of patients (n = 153) undergoing primary TLM for oropharyngeal SCC from 2006 to 2013 was studied. Human papillomavirus (HPV) status was determined by p16 immunohistochemistry and high-risk HPV DNA in situ hybridization. Survival analyses were evaluated using Kaplan–Meier statistics. Results: Tumor subsites included tonsil (n = 94; 61.5%), tongue base (n = 38; 24.8%), and soft palate (n = 21; 13.7%), with the majority being American Joint Committee on Cancer (AJCC) stage III/IVa (n = 124; 81.0%) and HPV-positive (n = 101; 66.0%). Three-year overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS) were 84.5%, 91.7%, and 78.2%, respectively. HPV-positivity portended favorable oncologic outcomes. One-year gastrostomy tube (G-tube) dependency was 1.3%. Conclusion: To the best of our knowledge, this is the largest single-center TLM oropharyngeal SCC series to date. Our data suggest that TLM +/− postoperative radiotherapy (PORT) results in at least as good oncologic outcomes as chemoradiotherapy (CRT), while conferring swallowing function advantages. © 2016 Wiley Periodicals, Inc. Head Neck, 2016 © 2016 Wiley Periodicals, Inc. Head Neck 38:1263–1270, 2016.

Item Type: Article
Uncontrolled Keywords: carcinoma, squamous cell/surgery, oropharyngeal neoplasms/surgery, laser therapy/methods, oropharyngeal neoplasms/mortality, neoplasm recurrence, local, survival analysis
Depositing User: Symplectic Admin
Date Deposited: 15 Jul 2016 10:02
Last Modified: 19 Jan 2023 07:33
DOI: 10.1002/hed.24432
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3002343