Department of Otolaryngology-Head and Neck Surgery, Washington University, Saint Louis, Missouri.
Division of Medical Oncology, Washington University, Saint Louis, Missouri.
Head Neck. 2019 May;41(5):1312-1319. doi: 10.1002/hed.25557. Epub 2018 Dec 11.
With most centers reporting excellent disease control following transoral surgery for human papillomavirus (HPV)-related oropharyngeal cancer, data are still lacking regarding management and outcomes in patients who relapse. We describe the treatment outcomes after curative intent therapy for locoregional and distant relapse following transoral surgery for HPV-related oropharyngeal squamous cell carcinoma (OPSCC).
A single institution retrospective study in which patients were identified with curatively treated loco-regional or single site distant relapse of HPV-related OPSCC treated initially with transoral surgery (TOS) between 1996 and 2014.
Among 279 patients, 38 (13.6%) relapsed. 21 (7.5%) had local-regional relapse and 18 were treated with curative intent. Three-year overall survival for loco-regional recurrence with curatively intended treatment was 75.3% (95% confidence intervals 54.3-96.0) with a median follow-up 33 (range: 5-65) months. Among 4 patients with isolated distant metastasis who were treated with curative intent, all subsequently developed second relapse of disease.
Salvage curative treatment of isolated local-regional relapse after TOS is associated with favorable prognosis and should be offered in appropriate candidates.
大多数中心报告称，经口手术治疗人乳头瘤病毒（HPV）相关口咽癌后疾病控制良好，但对于经口手术后复发患者的管理和结局数据仍缺乏。我们描述了经口手术治疗 HPV 相关口咽鳞状细胞癌（OPSCC）后局部区域和远处复发患者接受根治性治疗的治疗结果。
这是一项单机构回顾性研究，纳入了 1996 年至 2014 年间经口手术（TOS）初始治疗后发生 HPV 相关 OPSCC 局部区域或单一部位远处复发且接受根治性治疗的患者。
在 279 例患者中，有 38 例（13.6%）复发。21 例（7.5%）为局部区域复发，18 例接受了根治性治疗。局部区域复发且接受根治性治疗的患者的 3 年总生存率为 75.3%（95%置信区间为 54.3%-96.0%），中位随访时间为 33 个月（范围：5-65）。4 例孤立性远处转移患者接受了根治性治疗，所有患者随后均出现了疾病的第二次复发。
TOS 后孤立性局部区域复发的挽救性根治性治疗与良好的预后相关，应在合适的患者中提供。
