Impact of Different Treatment Concepts on Regional Failure in Advanced Oropharyngeal Cancer.
The management of patients with advanced oropharyngeal cancer is complex and mostly requires a multidisciplinary treatment approach. In general, organ preservation by primary concurrent radiochemotherapy (RCT), or surgery completed by adjuvant radiotherapy are established treatment strategies for these patients. However, it is unclear if primary treatment has an effect on regional tumor control. The purpose of the present study was to evaluate the regional control after different treatment concepts.



Clinical data, including histological and radiological results, of 82 patients with T2-T3 oropharyngeal cancer and N2 neck were retrospectively analyzed. They underwent either RCT with salvage neck dissection (ND) (n=45), or primary transoral surgery with ND and adjuvant RCT (n=37). In all cases, the primary tumor was successfully treated, without evidence of local failure in the follow-up.



Overall, 11 (13.4%) patients developed regional failure during the follow-up. There were no significant differences in frequency of regional failure (p=0.75), distant metastasis (p=0.35) and overall survival (p=0.22) between treatment groups. However, 5-year disease-free survival was significantly worse (39.0% vs. 57.0%) for patients treated by RCT, with more frequent regional failure detected compared to surgically-treated patients in univariate analysis (p=0.04).



Treatment concept does not seem to affect regional tumor control in advanced oropharyngeal cancer after successful treatment of the primary tumor.
Department of Otolaryngology, Head and Neck Surgery, Philipps University of Marburg, Marburg, Germany hochs@med.uni-marburg.de.
Stephan
S
Hoch
Department of Otolaryngology, Head and Neck Surgery, Philipps University of Marburg, Marburg, Germany.
Katharina
K
Thelen
Department of Radiotherapy and Radiooncology, Philipps University of Marburg, Marburg, Germany.
Hilke
H
Vorwerk
Department of Otolaryngology, Head and Neck Surgery, Philipps University of Marburg, Marburg, Germany.
Christoph
C
Netzer
Department of Otolaryngology, Head/Neck & Facial Plastic Surgery, Sana Kliniken Leipziger Land, Borna, Germany.
Thomas
T
Wilhelm
Department of Otolaryngology, Head and Neck Surgery, Borromäus Hospital, Leer, Germany.
Thomas
T
Günzel
Department of Otolaryngology, Head and Neck Surgery, Philipps University of Marburg, Marburg, Germany.
Afshin
A
Teymoortash
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D059248:Chemoradiotherapy / Q000379:methods; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D017211:Treatment Failure
Regional failure; oropharyngeal cancer; radiochemotherapy; transoral surgery