火曜抄読会;グンデゥズ准教授

 2018 Jun;128(6):1353-1364. doi: 10.1002/lary.26903. Epub 2017 Oct 8.

Primary surgery versus primary radiation-based treatment for locally advanced oropharyngeal cancer.

Figure 1 Flow diagram outlining exclusion criteria. AJCC = American Joint Committee on Cancer; aRT±CT = adjuvant radiotherapy with or without chemotherapy; CRT = chemoradiation; N = Nodal; Nx = unknown N stage; T = tumor; Tx = unknown tumor stage.
Figure 3 Kaplan‐Meier curve for overall survival in 22,676 stage III to IV oropharyngeal cancer patients receiving CRT versus surgery with adjuvant radiotherapy with or without chemotherapy (aRT ± CT). aRT±CT = adjuvant radiotherapy with or without chemotherapy; CRT = chemoradiation.

Conclusions by Dr. Guduz

  • Surgery+aRT±CT has better overall survival than CRT both in HPV restricted, HPV +, HPV-, and total populations

Limitatons

  • HPV status is only available from 2010
  • Data on chemotherapy type is lacking
  • Data on details of radiotherapy is lacking
  • Data on surgical technique and presence/absence of neck dissection
  • Comparison of less invasive techniques with open techniques not available
  • NCDB data lacking smoking status, local recurrence or toxicities
  • Functional outcomes such as speech and swallowing (factors of quality of life not evaluated

 

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