Ausburn Madeleine, Pyne Justin M, Day Andrew T, Hajnas Natalia, Moon Dominic, Myers Larry Leonard, Sher David Jonathan, Truelson John M, Tillman Brittny, Sumer Baran
Department of Otolaryngology, University of Texas at Southwestern Medical Center, Dallas, Texas, USA.
Laryngoscope. 2025 Aug;135(8):2777-2782. doi: 10.1002/lary.32091. Epub 2025 Mar 4.
The optimal margins for surgically treated human papilloma virus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) remain undefined. We evaluated the impact of surgical margins on progression-free survival (PFS) in patients with HPV+ OPSCC treated with primary transoral robotic surgery (TORS).
Patients undergoing primary TORS from May 2012 to December 2021 for intermediate-risk (T1-T2, resected to clear (≥ 3 mm) or close margins (< 3 mm), and N1-N2) HPV+ OPSCC were included. Survival outcomes were reviewed, and overall and PFS at 3 years posttreatment were determined using Kaplan-Meier analysis.
A total of 69 subjects met inclusion criteria. At a median follow-up of 47 months, overall survival (OS) was 100%, and the PFS was 88.9% for the entire subject group. Among subjects not receiving adjunctive radiotherapy (RT), those with close margins had an OS of 100% and a PFS of 100% (median follow-up 47 months). Subjects with clear margins had an OS probability of 100% and a PFS probability of 100% (median follow-up 47 months).
In subjects undergoing TORS for HPV+ OPSCC, clear margins did not confer a significant OS or PFS survival advantage compared to those with close margins, even when adjuvant therapy was omitted.
手术治疗人乳头瘤病毒（HPV）相关口咽鳞状细胞癌（OPSCC）的最佳切缘仍不明确。我们评估了手术切缘对接受初次经口机器人手术（TORS）治疗的HPV阳性OPSCC患者无进展生存期（PFS）的影响。
纳入2012年5月至2021年12月因中危（T1-T2，切除至切缘阴性（≥3mm）或切缘阳性（<3mm），且N1-N2）HPV阳性OPSCC接受初次TORS的患者。回顾生存结果，并使用Kaplan-Meier分析确定治疗后3年的总生存期和PFS。
共有69名受试者符合纳入标准。在中位随访47个月时，整个受试者组的总生存期（OS）为100%，PFS为88.9%。在未接受辅助放疗（RT）的受试者中，切缘阳性者的OS为100%，PFS为100%（中位随访47个月）。切缘阴性者的OS概率为100%，PFS概率为100%（中位随访47个月）。
在接受TORS治疗的HPV阳性OPSCC受试者中，即使省略辅助治疗，切缘阴性与切缘阳性相比，在OS或PFS方面未显示出显著的生存优势。
