Upfront surgery or definitive radiotherapy for patients with p16-negative oropharyngeal squamous cell carcinoma. A GETTEC multicentric study

Dorian Culié; Julien Viotti; Anouchka Modesto; Renaud Schiappa; Emmanuel Chamorey; Olivier Dassonville; Gilles Poissonnet; Bruno Guelfucci; Alain Bizeau; Sebastien Vergez; Agnes Dupret-Bories; Renaud Garrel; Nicolas Fakhry; Laure Santini; Benjamin Lallemant; Guillaume Chambon; Anne Sudaka; Frederic Peyrade; Esma Saada-Bouzid; Karen Benezery; Florence Jourdan-Soulier; Françoise Chapel; Anne Sophie Ramay; Pascal Roger; Thibault Galissier; Valérie Coste; Aicha Ben Lakdar; Joanne Guerlain; Stephane Temam; Haitham Mirghani; Phillipe Gorphe; Alexandre Bozec

doi:10.1016/j.ejso.2020.07.034

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Upfront surgery or definitive radiotherapy for patients with p16-negative oropharyngeal squamous cell carcinoma. A GETTEC multicentric study

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Upfront surgery or definitive radiotherapy for patients with p16-negative oropharyngeal squamous cell carcinoma. A GETTEC multicentric study

Dorian Culié, Julien Viotti, Anouchka Modesto, Renaud Schiappa, Emmanuel Chamorey, Olivier Dassonville, Gilles Poissonnet, Bruno Guelfucci, Alain Bizeau, Sebastien Vergez, …

European journal of surgical oncology, Vol.47(2), pp.367-374

02/2021

DOI: https://doi.org/10.1016/j.ejso.2020.07.034

PMID: 33004271

Résumé

Cancer

Human papilloma virus

Oropharynx

Radiotherapy

Surgery

Treatment

Therapeutic management of oropharyngeal squamous cell carcinomas (OPSCC) is still debated. Since the role of HPV was demonstrated, few studies have focused on HPV-negative OPSCC. The aim of our study was to assess the impact of therapeutic strategy (surgical vs. non-surgical) on oncologic outcomes in patients with HPV-negative OPSCC. All p16-negative OPSCCs treated from 2009 to 2014 in 7 tertiary-care centers were included in this retrospective study and were classified according to the therapeutic strategy: surgical strategy (surgery ± adjuvant radiotherapy and chemotherapy) vs. non-surgical strategy (definitive radiotherapy ± chemotherapy). Patients not eligible for surgery (unresectable tumor, poor general-health status) were excluded. Univariate, multivariate and propensity score matching analyses were performed to compare overall (OS), disease-specific (DSS) and recurrence-free survival (RFS). Four hundred seventy-four (474) patients were included in the study (surgical group: 196; non-surgical group: 278). Five-year OS, DSS and RFS were 76.5, 81.3 and 61.3%, respectively, in the surgical group and 49.9, 61.8 and 43.4%, respectively, in the non-surgical group. The favorable impact of primary surgical treatment on oncologic outcomes was statistically significant after multivariate analysis. This effect was more marked for locally-advanced than for early-stage tumors. Propensity score matching analysis confirmed the prognostic impact of primary surgical treatment for RFS. Therapeutic strategy is an independent prognostic factor in patients with p16-negative OPSCC and primary surgical treatment is associated with improved OS, DSS and RFS. These results suggest that surgical strategy is a reliable option for advanced stage OPSCC.

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Titre: Upfront surgery or definitive radiotherapy for patients with p16-negative oropharyngeal squamous cell carcinoma. A GETTEC multicentric study
Créateurs - sans rôle: Dorian Culié - University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d’Azur University, Nice, France
Julien Viotti - Department of Statistics, Antoine Lacassagne Centre, Côte d’Azur University, Nice, France
Anouchka Modesto - Department of Radiotherapy, Cancer University Institute of Toulouse, Toulouse, France
Renaud Schiappa - Department of Statistics, Antoine Lacassagne Centre, Côte d’Azur University, Nice, France
Emmanuel Chamorey - Department of Statistics, Antoine Lacassagne Centre, Côte d’Azur University, Nice, France
Olivier Dassonville - University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d’Azur University, Nice, France
Gilles Poissonnet - University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d’Azur University, Nice, France
Bruno Guelfucci - Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
Alain Bizeau - Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
Sebastien Vergez - Department of Otorhinolaryngology and Head and Neck Surgery, Cancer University Institute of Toulouse, Toulouse, France
Agnes Dupret-Bories - Department of Otorhinolaryngology and Head and Neck Surgery, Cancer University Institute of Toulouse, Toulouse, France
Renaud Garrel - Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Montpellier, Montpellier, France
Nicolas Fakhry - Department of Otorhinolaryngology and Head and Neck Surgery, Public Assistance - Hospitals of Marseille, Marseille, France
Laure Santini - Department of Otorhinolaryngology and Head and Neck Surgery, Public Assistance - Hospitals of Marseille, Marseille, France
Benjamin Lallemant - Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, Nîmes, France
Guillaume Chambon - Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, Nîmes, France
Anne Sudaka - Department of Pathology, Antoine Lacassagne Centre, Côte d’Azur University, Nice, France
Frederic Peyrade - Department of Medical Oncology, Antoine Lacassagne Centre, Côte d’Azur University, Nice, France
Esma Saada-Bouzid - Department of Medical Oncology, Antoine Lacassagne Centre, Côte d’Azur University, Nice, France
Karen Benezery - Department of Radiotherapy, Antoine Lacassagne Centre, Côte d’Azur University, Nice, France
Florence Jourdan-Soulier - Department of Pathology, Sainte Musse Hospital, Toulon, France
Françoise Chapel - Department of Pathology, Sainte Musse Hospital, Toulon, France
Anne Sophie Ramay - Department of Pathology, University Hospital of Nîmes, Nîmes, France
Pascal Roger - Department of Pathology, University Hospital of Nîmes, Nîmes, France
Thibault Galissier - Department of Pathology, Cancer University Institute of Toulouse, Toulouse, France
Valérie Coste - Department of Pathology, University Hospital of Montpellier, Montpellier, France
Aicha Ben Lakdar - Department of Pathology, Gustave Roussy Institute, Villejuif, France
Joanne Guerlain - Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
Stephane Temam - Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
Haitham Mirghani - Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
Phillipe Gorphe - Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
Alexandre Bozec - University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d’Azur University, Nice, France
Détails de publication: European journal of surgical oncology, Vol.47(2), pp.367-374
Éditeur: Elsevier Ltd
Nombre de pages: 8
Identifiants: 99162669109311
Unité académique: Institut de Recherche en Cancérologie de Montpellier - IRCM; Recherche hors université
Langue: English
Type de ressource: Journal article