Neoadjuvant chemotherapy and transoral surgery as a definitive treatment for oropharyngeal cancer: A feasible novel approach

Background The purpose of this study was to present our evaluation of the outcome of oropharyngeal cancer managed with neoadjuvant chemotherapy and transoral surgery (TOS) with neck dissection as definitive treatment. Methods This is a case series of 17 patients with advanced oropharyngeal cancer wh...

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Bibliographic Details
Published in:Head & neck 2016-12, Vol.38 (12), p.1837-1846
Main Authors: Sadeghi, Nader, Li, Ning-Wei, Taheri, M. Reza, Easley, Samantha, Siegel, Robert S.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Carcinoma, Squamous Cell - drug therapy
Carcinoma, Squamous Cell - mortality
Carcinoma, Squamous Cell - pathology
Carcinoma, Squamous Cell - surgery
Cohort Studies
Databases, Factual
Disease-Free Survival
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Neck Dissection - methods
neoadjuvant chemotherapy
Neoadjuvant Therapy - methods
oropharyngeal cancer
Oropharyngeal Neoplasms - drug therapy
Oropharyngeal Neoplasms - mortality
Oropharyngeal Neoplasms - pathology
Oropharyngeal Neoplasms - surgery
Prognosis
Retrospective Studies
Risk Assessment
robotic surgery
Survival Analysis
transoral laser microsurgery
transoral surgery
Treatment Outcome
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Summary:Background The purpose of this study was to present our evaluation of the outcome of oropharyngeal cancer managed with neoadjuvant chemotherapy and transoral surgery (TOS) with neck dissection as definitive treatment. Methods This is a case series of 17 patients with advanced oropharyngeal cancer who were treated with neoadjuvant chemotherapy followed by TOS. The treatment details and oncologic outcome are reported. The volumetric response of the tumor to neoadjuvant chemotherapy is evaluated and validated by histopathology. Results Seventeen patients with TNM stages III and IV oropharyngeal cancer constitute this series for survival analysis. On a median and mean follow‐up of 31 and 40 months, respectively, 16 of the 17 patients were alive without recurrence. Disease‐specific survival (DSS) and overall survival (OS) at 3 years were 94.1%. Conclusion Adjuvant chemotherapy followed by TOS and neck dissection is a feasible and efficacious novel therapeutic approach for definitive management of moderately advanced oropharyngeal cancer, reserving radiotherapy (RT) for salvage or adverse features. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1837–1846, 2016
ISSN:1043-3074
1097-0347
DOI:10.1002/hed.24526