Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, MI, Italy; Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, MI, Italy; Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Experimental Medicine (DIMES), University of Genoa, Genoa, Italy.
Eur J Surg Oncol. 2023 Dec;49(12):107121. doi: 10.1016/j.ejso.2023.107121. Epub 2023 Oct 18.
To analyze the oncological outcomes and patterns of recurrence of patients with locoregionally advanced oropharyngeal squamous cell carcinoma (OPSCC) who underwent neo-adjuvant chemotherapy (NCT) with subsequent transoral robotic surgery (TORS).
A single-center retrospective cohort study was performed, including 198 patients (mean age: 58.6, SD: 9.2). The primary outcome was disease-free survival (DFS).
The median follow-up time was 26.5 months (IQR: 16.0-52.0). Estimated DFS rates (95 % CI) at 1 and 3 years were 86.6 % (81.9-91.7), and 81.4 % (75.7-87.6), respectively. Estimated DSS rates (95 % CI) at 1 and 3 years were 96.7 % (94.1-99.3), and 92.6 % (88.4-97.0), respectively. Estimated OS rates (95 % CI) at 1 and 3 years were 96.2 % (93.4-99.0), and 88.7 % (83.4-94.2), respectively. A total of 31 (15.6 %) patients showed a disease relapse after a median time of 8 months (IQR: 4.0-12.0), but only 12 (6 %) patients died of the disease during the study period.
This study demonstrates that NCT and TORS can obtain excellent tumor control and survival in locoregionally advanced OPSCC. NCT might reduce the need for adjuvant treatments, and randomized clinical trials should be conducted to better define this aspect.
分析接受新辅助化疗（NCT）联合经口机器人手术（TORS）的局部晚期或口咽鳞状细胞癌（OPSCC）患者的肿瘤学结局和复发模式。
进行了一项单中心回顾性队列研究，纳入了 198 例患者（平均年龄：58.6，SD：9.2）。主要结局是无病生存（DFS）。
中位随访时间为 26.5 个月（IQR：16.0-52.0）。1 年和 3 年时估计的 DFS 率（95%CI）分别为 86.6%（81.9-91.7）和 81.4%（75.7-87.6）。1 年和 3 年时估计的 DSS 率（95%CI）分别为 96.7%（94.1-99.3）和 92.6%（88.4-97.0）。1 年和 3 年时估计的 OS 率（95%CI）分别为 96.2%（93.4-99.0）和 88.7%（83.4-94.2）。中位时间为 8 个月（IQR：4.0-12.0）时，共有 31 例（15.6%）患者出现疾病复发，但在研究期间仅有 12 例（6%）患者死于该疾病。
本研究表明，NCT 和 TORS 可在局部晚期 OPSCC 中获得出色的肿瘤控制和生存效果。NCT 可能减少辅助治疗的需求，应开展随机临床试验以更好地明确这一方面。
