Enhancing regional control in p16-negative oropharyngeal cancer : A propensity score-matched analysis of upfront neck dissection and definitive chemoradiotherapy
Copyright © 2024, the Chinese Medical Association..
BACKGROUND: The presence of p16 and neck disease are important predictors of prognosis for oropharyngeal squamous cell carcinoma (OPSCC). Patients who are p16-negative and have clinically node-positive (cN+) disease generally have worse oncologic outcomes. This study aimed to investigate whether upfront neck dissection (UFND) could provide potential benefits for patients with cN+ p16-negative OPSCC.
METHODS: Through this retrospectively study, 76 patients with cN+ p16-negative OPSCC were analyzed, those who received either definite concurrent chemoradiotherapy (CCRT group) or UFND followed by chemoradiotherapy (UFND group). The primary endpoints were regional recurrence-free survival (RRFS), disease-specific survival (DSS), and overall survival (OS). Factors associated with survival were evaluated by univariate and multivariate analysis. Survival between the two groups was compared by propensity score-matched analysis.
RESULTS: Matched 23 patients in each group through propensity analysis, the UFND group showed a significantly better 5-year RRFS (94.1% vs. 61.0%, p=0.011) compared to the CCRT group. Univariate analysis revealed that UFND was the sole factor associated with regional control (HR=0.110; 95% CI, 0.014-0.879; p=0.037). Furthermore, the study found that the CCRT group was associated with a higher dose of radiotherapy and exhibited a significantly higher risk of mortality due to pneumonia.
CONCLUSION: The study indicated that UFND followed by CCRT may be a potential treatment option for patients with cN+ p16-negative OPSCC, as it can reduce the risk of regional recurrence. Additionally, the study highlights that definite CCRT is connected to a larger dose of radiotherapy and a higher risk of fatal pneumonia. These findings could be beneficial in informing clinical decision-making and improving treatment outcomes for patients with OPSCC.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Journal of the Chinese Medical Association : JCMA - (2024) vom: 19. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lee, Tsung-Lun [VerfasserIn] |
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Date Revised 19.03.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1097/JCMA.0000000000001085 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369914333 |
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| 100 | 1 | |a Lee, Tsung-Lun |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Enhancing regional control in p16-negative oropharyngeal cancer |b A propensity score-matched analysis of upfront neck dissection and definitive chemoradiotherapy |
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| 520 | |a Copyright © 2024, the Chinese Medical Association. | ||
| 520 | |a BACKGROUND: The presence of p16 and neck disease are important predictors of prognosis for oropharyngeal squamous cell carcinoma (OPSCC). Patients who are p16-negative and have clinically node-positive (cN+) disease generally have worse oncologic outcomes. This study aimed to investigate whether upfront neck dissection (UFND) could provide potential benefits for patients with cN+ p16-negative OPSCC | ||
| 520 | |a METHODS: Through this retrospectively study, 76 patients with cN+ p16-negative OPSCC were analyzed, those who received either definite concurrent chemoradiotherapy (CCRT group) or UFND followed by chemoradiotherapy (UFND group). The primary endpoints were regional recurrence-free survival (RRFS), disease-specific survival (DSS), and overall survival (OS). Factors associated with survival were evaluated by univariate and multivariate analysis. Survival between the two groups was compared by propensity score-matched analysis | ||
| 520 | |a RESULTS: Matched 23 patients in each group through propensity analysis, the UFND group showed a significantly better 5-year RRFS (94.1% vs. 61.0%, p=0.011) compared to the CCRT group. Univariate analysis revealed that UFND was the sole factor associated with regional control (HR=0.110; 95% CI, 0.014-0.879; p=0.037). Furthermore, the study found that the CCRT group was associated with a higher dose of radiotherapy and exhibited a significantly higher risk of mortality due to pneumonia | ||
| 520 | |a CONCLUSION: The study indicated that UFND followed by CCRT may be a potential treatment option for patients with cN+ p16-negative OPSCC, as it can reduce the risk of regional recurrence. Additionally, the study highlights that definite CCRT is connected to a larger dose of radiotherapy and a higher risk of fatal pneumonia. These findings could be beneficial in informing clinical decision-making and improving treatment outcomes for patients with OPSCC | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Fang, Wei Chen |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, I-Cheng |e verfasserin |4 aut | |
| 700 | 1 | |a Lirng, Jiing-Feng |e verfasserin |4 aut | |
| 700 | 1 | |a Chang, Chia-Fan |e verfasserin |4 aut | |
| 700 | 1 | |a Hsu, Yen-Bin |e verfasserin |4 aut | |
| 700 | 1 | |a Chu, Pen-Yuan |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Yi-Fen |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Muh-Hwa |e verfasserin |4 aut | |
| 700 | 1 | |a Chang, Peter Mu-Hsin |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Ling-Wei |e verfasserin |4 aut | |
| 700 | 1 | |a Tai, Shyh-Kuan |e verfasserin |4 aut | |
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