Abstract
PurposeOnly a minority of patients with oropharyngeal squamous cell carcinoma (OPSCC) are diagnosed without regional metastasis (cN0). Studies focusing on the management of cN0 neck in OPSCC are scarce.MethodsWe reviewed all OPSCC patients treated at our institution with cN0 neck between 2000 and 2009. The treatment of neck and pattern of regional control was analyzed. Median follow-up was 5 years (range 3.5–9.0) or until death.ResultsOf the total 313 OPSCC patients treated within the period, 56 (18%) presented with cN0 neck. Of them, 51 (91%) received completed treatment with curative intent: 46 (90%) underwent elective neck treatment with either neck dissection ± (chemo)radiotherapy (C)RT (n = 23) or (C)RT (n = 23). A regional recurrence occurred in three patients (6%) and they all had a p16-negative soft palate midline primary tumor. Two of these patients had received RT on the neck.ConclusionsWhile the overall prognosis of OPSCC is generally favorable and regional recurrences are infrequent, soft palate tumors, that are usually p16 negative, may form an subgroup warranting more aggressive treatment despite the clinical appearance of early stage.
Highlights
One of the most current issues in head and neck oncology is the treatment of oropharyngeal squamous cell carcinoma (OPSCC) [1, 2]
It has been shown to have remarkably better prognosis compared with HPV non-related OPSCC, which is typically associated with long-term tobacco and alcohol consumption [4]
Single treatment modality was given to 10 patients, definitive CRT was delivered to 15 patients, and 26 underwent surgery followed by (C)RT
Summary
One of the most current issues in head and neck oncology is the treatment of oropharyngeal squamous cell carcinoma (OPSCC) [1, 2]. The incidence of the HPV-related OPSCC is increasing [3]. It has been shown to have remarkably better prognosis compared with HPV non-related OPSCC, which is typically associated with long-term tobacco and alcohol consumption [4]. This has raised concern about possible overtreatment of HPV-related OPSCC and unnecessary treatment-related morbidity [5]. Ongoing studies are examining whether the treatment of patients diagnosed with
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