Sampieri Claudio, Cioccoloni Eleonora, Costantino Andrea, Kim Dahee, Lee Kyuin, Meccariello Giuseppe, Cammaroto Giovanni, Vicini Claudio, Kim Se-Heon
Functional Unit of Head and Neck Tumors, Hospital Clínic, Barcelona, Spain.
Department of Otorhinolaryngology, Hospital Clínic, Barcelona, Spain.
Head Neck. 2025 Jan;47(1):175-188. doi: 10.1002/hed.27904. Epub 2024 Aug 1.
Transoral robotic surgery (TORS) performed after neoadjuvant chemotherapy (NAC) is a promising treatment for advanced-stage oropharyngeal carcinoma (OPSCC) able to reduce the adjuvant therapy administration rate.
A retrospective bi-centric study was conducted to analyze NAC + TORS versus upfront TORS patients. A 1:1 propensity score matching was used to compare the two groups.
Among the 300 patients with stage III-IV OPSCC, 204 patients were matched for comparing NAC + TORS versus upfront TORS. Between the two groups, no significant difference was observed in recurrences and in survival for RFS, OS, and DSS. In the NAC + TORS p16-positive population, adjuvant therapy could be spared in 51% versus 16% in the upfront surgery cohort (p < 0.001) due to the lower frequency of pathological risk factors after NAC.
NAC followed by TORS for locoregionally advanced OPSCC demonstrated to achieve non-inferior survival outcomes to upfront surgery, while in the p16-positive population allowed to significantly spare adjuvant therapy.
新辅助化疗（NAC）后行经口机器人手术（TORS）是晚期口咽癌（OPSCC）一种有前景的治疗方法，能够降低辅助治疗的施用率。
开展一项回顾性双中心研究，分析接受NAC + TORS治疗的患者与直接接受TORS治疗的患者。采用1:1倾向评分匹配法对两组进行比较。
在300例III-IV期OPSCC患者中，204例患者进行了匹配，以比较NAC + TORS组与直接TORS组。两组之间，在复发率以及无复发生存期（RFS）、总生存期（OS）和疾病特异性生存期（DSS）方面未观察到显著差异。在NAC + TORS的p16阳性人群中，51%的患者可免于辅助治疗，而直接手术组这一比例为16%（p < 0.001），因为NAC后病理危险因素的发生率较低。
对于局部晚期OPSCC，NAC后行TORS显示出与直接手术相当的生存结果，而在p16阳性人群中可显著减少辅助治疗。
