Transoral robotic surgery with neck dissection versus nonsurgical treatment in stage I and II human papillomavirus-negative oropharyngeal cancer

Craig A. Bollig, Brian Morris, Vanessa C. Stubbs

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: Surgery + adjuvant therapy was shown to have improved overall survival (OS) versus nonsurgical treatment in T1-T2N1-N2b human papillomavirus (HPV)-negative oropharyngeal cancer (OPC). Our objective was to compare OS in transoral robotic surgery (TORS) with neck dissection versus nonsurgical treatment for T1-T2N0 HPV-negative OPC. Methods: Patients with T1-T2N0 HPV-negative OPC were identified in the National Cancer Database. OS was compared between groups: (1) TORS with neck dissection +/− adjuvant therapy, (2) primary radiotherapy (>60 Gy) +/− chemotherapy using Kaplan–Meier and multivariable Cox proportional hazards models. Results: There were 665 (78.4%) patients treated nonsurgically and 183 (21.6%) patients in the TORS group. Adjusting for age, comorbidity score, facility type, tumor subsite, and tumor stage, primary nonsurgical treatment was associated with worse OS (hazard ratio: 1.90, 95% CI: 1.34–2.69). Conclusion: For T1-T2N0 HPV-negative OPC, TORS with neck dissection may be associated with a survival benefit over nonsurgical treatment.

Original languageEnglish (US)
Pages (from-to)1545-1553
Number of pages9
JournalHead and Neck
Volume44
Issue number7
DOIs
StatePublished - Jul 2022

All Science Journal Classification (ASJC) codes

  • Otorhinolaryngology

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