Ten-Year Efficacy of Transoral Surgery for Squamous Carcinoma of the Lateral Oropharynx.

Laryngoscope

Division of Head & Neck Surgery, Department of Otolaryngology, Stanford University, Palo Alto, California, U.S.A.

Published: November 2024

Objectives: To document the 10-year results of transoral mandibular preservation surgery for patients with T1-2 squamous cell carcinoma (SCC) arising from the lateral oropharynx.

Methods: This was a retrospective 30-year review using STROBE guidelines at an academic, tertiary referral center. A total of 294 patients with T1-2 SCC of the lateral oropharynx were reviewed. Only 19% of patients were never-smokers, suggesting a predominantly HPV-negative population. All patients had transoral mandibular preservation surgery. Follow-up therapy included neck dissection (76.5%), induction chemotherapy (57.8%), and postoperative radiation therapy (31.6%) Local control, survival, and functional endpoints, as well as the consequences of local recurrence, were analyzed.

Results: The 10-year local disease control was 88.3%. Local recurrence was salvaged in 50% of cases, resulting in an overall 94.5% local control rate. The overall 10-year survival was 50%. Mortality was related to metachronous second primary cancer (MSPC) (29.2%), medical comorbidities (25.7%), uncontrolled local recurrence (10%), and complications following transoral resection (4.2%). In multivariate analysis, the development of an MSPC significantly increased (p < 0.005) the risk of death. Overall, 95.2% of patients achieved mandibular preservation. However, gastrostomy and tracheostomy dependence occurred in 1% and 0.3% of cases, respectively.

Conclusions: For a patient population with a significant percentage of tobacco-associated oropharyngeal cancer (OPC), transoral surgery was associated with long-term minimal postoperative complications and a high rate of local control. MSPC was the main cause of death during the first 10 postoperative years. Such long-term figures support transoral surgery as an effective first-line treatment for early-stage predominantly tobacco-related OPC.

Level Of Evidence: 4 Laryngoscope, 134:4564-4572, 2024.

Download full-text PDF

Source
http://dx.doi.org/10.1002/lary.31574DOI Listing

Publication Analysis

Top Keywords

local recurrence
12
lateral oropharynx
8
transoral mandibular
8
mandibular preservation
8
preservation surgery
8
patients t1-2
8
local control
8
local
6
ten-year efficacy
4
transoral
4

Similar Publications

Background: We investigated the perioperative outcome and oncologic safety of performing nipple-sparing mastectomy (NSM) through a single axillary incision (NSM-SAI) compared with performing NSM through a conventional incision (NSM-C).

Methods: We retrospectively reviewed 725 patients who underwent NSM for breast cancer between January 2010 and December 2023; 333 patients who underwent NSM with immediate reconstruction (IR) were enrolled. Surgical outcomes and oncologic outcomes of NSM-C (n = 184), NSM performed through SAI with a freehand approach (NSM-SAI-F; n = 92), and with an endoscopic approach (NSM-SAI-E; n = 57) were demonstrated.

View Article and Find Full Text PDF

Renal cell carcinoma metastasis to the thyroid gland: a case report.

J Med Case Rep

December 2024

Laboratory of Pathology Pathology, "CSD Health Care", Kiev, Ukraine.

Background: In this article, we report a case of renal cell carcinoma metastasis to the thyroid gland. Occult lesions of the thyroid were treated with a thyroidectomy. The case history presented below describes the patient's pathway and subsequent results.

View Article and Find Full Text PDF

Circulating tumor DNA detection improves relapse prediction in epithelial ovarian cancer.

BMC Cancer

December 2024

Department of Obstetrics and Gynecology, National Clinical Research Centre for Obstetric and Gynecologic Diseases, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Background: Epithelial ovarian cancer (EOC) is a lethal form of gynecological malignancy. Some EOC patients experience relapse after standard primary debulking surgery (PDS) and adjuvant chemotherapy (ACT). Identifying molecular residual disease (MRD) by circulating tumor DNA (ctDNA) detection can timely signal the potential for relapse.

View Article and Find Full Text PDF

[Surgery for phyllodes tumors of the breast: Is the denomination of a giant phyllodes tumor justified?].

Ann Chir Plast Esthet

December 2024

Service de chirurgie générale, pavillon militaire du CHU Sylvanus Olympio, Togo.

Introduction: In Africa, rare publications have focused on phyllodes tumors (PTs). The aim of our study is to describe the special feature of PTs surgery.

Patients And Method: Retrospective and descriptive study of 11 cases of PT operated from January 1, 2015 to March 31, 2023 at the medical-surgical clinic in Teaching Hospital Center of Sylvanus Olympio of Lome.

View Article and Find Full Text PDF

Objective: To assess urological complications in patients undergoing total pelvic exenteration (TPE) for locally advanced (LARC) and recurrent rectal cancer (RRC) as publications in this area are limited. Secondary objectives were to assess whether LARC vs RRC or radiation status affected urological outcomes.

Methods: Single-centre, retrospective study of TPE patients between January 2017 and December 2022.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!