Evolution in the management of oropharyngeal squamous cell carcinoma: systematic review of outcomes over the last 25 years

The treatment of oropharyngeal squamous cell carcinoma (SCC) has evolved over the last 25years, from open surgery to combined chemoradiotherapy, and now to the development of minimally invasive procedures, but evidence for the best treatment is lacking. We therefore did a systematic search of the ME...

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Bibliographic Details
Published in:British journal of oral & maxillofacial surgery 2019-02, Vol.57 (2), p.101-115
Main Authors: Maschio, F., Lejuste, P., Ilankovan, V.
Format: Article
Language:English
Subjects:
Carcinoma, Squamous Cell
Dentistry
Humans
Management
Oropharyngeal Neoplasms
Oropharyngeal Squamous Cell Carcinoma
Outcomes
Papillomavirus Infections
Prospective Studies
Retrospective Studies
Systematic Review
Treatment
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Summary:The treatment of oropharyngeal squamous cell carcinoma (SCC) has evolved over the last 25years, from open surgery to combined chemoradiotherapy, and now to the development of minimally invasive procedures, but evidence for the best treatment is lacking. We therefore did a systematic search of the MEDLINE database for studies published between 1992 and 2017 that reported oncological or functional outcomes, or both. Predefined inclusion and exclusion criteria were used for screening and selection, and 45 studies were chosen. Only one was a randomised controlled trial, all the rest were prospective or retrospective case series. The heterogeneities in their characteristics made meta-analysis impossible and only qualitative analysis was feasible. We found no conclusive evidence to suggest the advantage of one therapeutic approach over another, so we still cannot offer patients the “ideal” treatment. We have, however, raised the possibility of there being two different entities: human papillomavirus (HPV)-positive and HPV-negative disease.
ISSN:0266-4356
1532-1940
DOI:10.1016/j.bjoms.2018.12.006