TITLE:
Does Surgery Have a Relevant Role in the Primary Treatment of Locoregionally Advanced Oropharyngeal Carcinomas?
AUTHORS:
Joana Guimarães, Sara Cruz, Eduardo Breda, Eurico Monteiro
KEYWORDS:
Oropharyngeal Carcinoma; Treatment; Concurrent Chemoradiotherapy; Primary Surgical Resection; Survival Rates
JOURNAL NAME:
International Journal of Otolaryngology and Head & Neck Surgery,
Vol.2 No.6,
November
11,
2013
ABSTRACT:
Background: Treatment concepts for oropharyngeal squamous cell carcinomas are
controversial. This review compares the results obtained by distinct treatment
options in locoregionally oropharyngeal advanced carcinomas: primary surgical
resection followed by concurrent chemoradiotherapy and concurrent
chemoradiotherapy alone. Methods: 57
patients with stage III and IV oropharyngeal squamous cell carcinoma
were selected. 17 patients were treated with primary surgical
resection followed by concurrent chemoradiotherapy and 40 patients were treated
only with concurrent chemoradiotherapy. Statistical analysis was performed
regarding survival rates according to tumor location, stage, treatment regimen
and recurrence. Results: Two-year
loco-regional control rates were 94% after surgery plus chemoradiotherapy
and 55% after chemoradiotherapy (p = 0.016). Progression free survival rates were
88% and 27%, respectively (p 0.001). Overall survival rates were 88% and
45%, respectively (p = 0.002). Conclusions: In this study, primary surgical resection followed by concurrent chemoradiotherapy
showed better clinical outcomes with a lower risk of death associated with
tumor and tumor progression.