Transoral Surgery Versus Radiotherapy as Primary Treatment for HPV-Related Oropharyngeal Cancer in the Elderly.
Abstract
[BACKGROUND] This study compares the oncological outcomes of primary transoral surgery (TOS) and primary radiotherapy (RT) in elderly patients with HPV-related oropharyngeal squamous cell carcinoma (OPSCC).
[METHODS] This retrospective cohort study included patients with cT1-2 HPV-related OPSCC from the National Cancer Database (NCDB).
[RESULTS] A total of 2566 patients were included, with 73.9% receiving primary RT and 22.3% undergoing primary TOS. Subgroup analysis showed a higher 5-year overall survival (OS) rate for primary TOS (81.6%; 95% CI: 79.6%-83.6%) compared to primary RT (70.7%; 95% CI: 68.3%-73.1%), with an adjusted hazard ratio (HR) of 0.64 (95% CI: 0.50-0.81; p < 0.001) after propensity score matching. Notably, only (13.6%) of patients diagnosed in 2020 underwent primary TOS, with a significant decline over the study period.
[CONCLUSIONS] This study suggests that primary TOS may offer better survival outcomes for elderly patients with HPV-related OPSCC compared to primary RT.
[METHODS] This retrospective cohort study included patients with cT1-2 HPV-related OPSCC from the National Cancer Database (NCDB).
[RESULTS] A total of 2566 patients were included, with 73.9% receiving primary RT and 22.3% undergoing primary TOS. Subgroup analysis showed a higher 5-year overall survival (OS) rate for primary TOS (81.6%; 95% CI: 79.6%-83.6%) compared to primary RT (70.7%; 95% CI: 68.3%-73.1%), with an adjusted hazard ratio (HR) of 0.64 (95% CI: 0.50-0.81; p < 0.001) after propensity score matching. Notably, only (13.6%) of patients diagnosed in 2020 underwent primary TOS, with a significant decline over the study period.
[CONCLUSIONS] This study suggests that primary TOS may offer better survival outcomes for elderly patients with HPV-related OPSCC compared to primary RT.
추출된 의학 개체 (NER)
| 유형 | 영어 표현 | 한국어 / 풀이 | UMLS CUI | 출처 | 등장 |
|---|---|---|---|---|---|
| 약물 | TOS
→ transoral surgery
|
C2984589
Transoral Laser Microsurgery
|
scispacy | 1 | |
| 약물 | [BACKGROUND]
|
scispacy | 1 | ||
| 약물 | [RESULTS] A
|
scispacy | 1 | ||
| 약물 | [CONCLUSIONS]
|
scispacy | 1 | ||
| 질환 | Oropharyngeal Cancer
|
C0153382
Malignant neoplasm of oropharynx
|
scispacy | 1 | |
| 질환 | HPV-related oropharyngeal squamous cell carcinoma
|
scispacy | 1 | ||
| 질환 | OPSCC
→ oropharyngeal squamous cell carcinoma
|
C0280313
Oropharyngeal Squamous Cell Carcinoma
|
scispacy | 1 | |
| 질환 | Cancer
|
C0006826
Malignant Neoplasms
|
scispacy | 1 | |
| 질환 | HPV-related OPSCC
|
scispacy | 1 | ||
| 질환 | cT1-2 HPV-related OPSCC
|
scispacy | 1 | ||
| 질환 | TOS
→ transoral surgery
|
scispacy | 1 | ||
| 기타 | patients
|
scispacy | 1 | ||
| 기타 | TOS
→ transoral surgery
|
scispacy | 1 |
MeSH Terms
Humans; Oropharyngeal Neoplasms; Aged; Retrospective Studies; Male; Female; Papillomavirus Infections; Aged, 80 and over; Treatment Outcome; Propensity Score; Carcinoma, Squamous Cell; Middle Aged; Natural Orifice Endoscopic Surgery; Databases, Factual; Survival Rate