title: Definitive Surgical Therapy after Open Neck Biopsy for HPV-Related Oropharyngeal Cancer.
abstract: OBJECTIVE
  To determine the impact of prior open neck biopsy on the prognosis of patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) who are subsequently treated with a definitive surgical paradigm, including adjuvant therapy when indicated.
  
  
  METHODS
  Retrospective cohort.
  
  
  METHODS
  Tertiary care university hospital.
  
  
  METHODS
  Patients with open neck biopsies who were treated with definitive surgery, with or without adjuvant therapy, for HPV-related OPSCC between 1998 and 2012 were compared with a matched control group who did not undergo open neck biopsy. Outcomes were disease-free survival, overall survival, disease-specific survival, incidence of tumor deposit in dermal scar, patterns of recurrence, and neck dissection complications.
  
  
  RESULTS
  Forty-five patients who underwent open neck biopsy were compared with 90 matched controls. Tumor deposits in dermal scars from the prior open neck biopsy were found in 3 patients (7%) during completion neck dissection. Overall complications of the neck dissection were not significantly increased in the open biopsy group over matched controls (20% vs 12%, respectively; P > .05). Five-year Kaplan-Meier estimates for disease-free survival, overall survival, and disease-specific survival were not significantly different between the open biopsy and control groups (93% vs 91%, 98% vs 97%, 98% vs 99%, respectively; all P > .05). Recurrence rates were also not significantly different between groups.
  
  
  CONCLUSIONS
  Patients with HPV-related OPSCC who have undergone a prior open neck biopsy can be successfully treated with a definitive surgical paradigm. Although needle biopsy is preferable to establish a diagnosis, previous open neck biopsy does not affect prognosis in these patients.
authors: Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA.
authors: Joseph
authors: J
authors: Zenga
authors: Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA.
authors: Evan M
authors: EM
authors: Graboyes
authors: Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA.
authors: Bruce H
authors: BH
authors: Haughey
authors: Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA.
authors: Randal C
authors: RC
authors: Paniello
authors: Department of Pathology, Washington University School of Medicine, St Louis, Missouri, USA.
authors: Mitra
authors: M
authors: Mehrad
authors: Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors: James S
authors: JS
authors: Lewis
authors: Department of Radiation Oncology, Washington University School of Medicine, St Louis, Missouri, USA.
authors: Wade L
authors: WL
authors: Thorstad
authors: Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA.
authors: Brian
authors: B
authors: Nussenbaum
authors: Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA richj@ent.wustl.edu.
authors: Jason T
authors: JT
authors: Rich
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery* / Q000821:virology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000601:surgery* / Q000821:virology*; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
keywords: HPV; TLM; excisional biopsy; human papillomavirus; incisional biopsy; open neck biopsy; oropharyngeal carcinoma; p16; transoral surgery