Abstract
Background: Since most oropharyngeal carcinomas are locally advanced at presentation, patients are often treated with radiation therapy and/or chemotherapy. However, for early stage oropharyngeal carcinoma, national guidelines state that it can be treated by either primary surgery or radiotherapy. This study analyse national survival rates of oropharyngeal squamous cell carcinoma for surgical and nonsurgical treatment modalities. Methods: All cases of squamous cell carcinoma of the oropharynx between 1988 and 2007 were selected from the Surveillance, Epidemiology and End Results (SEER) 17 database. The SEER database is a population-based cancer registry that captures 17 distinct population groups in 198 counties in the United States. It represents approximately 26% of the overall United States population and contains information on 6,117,327 cases of cancer diagnosed since 1973. Overall survival was the primary outcome measure. Survival curves were generated using the Kaplan-Meier method and compared using the Mantel-Cox log-rank test. Significance was defined as P<0.05. You can submit your Manuscripts at: https://symbiosisonlinepublishing.com/submitManuscript.php
Highlights
Since most oropharyngeal carcinomas are locally advanced at presentation, patients are often treated with radiation therapy and/or chemotherapy
For early oropharyngeal squamous cell carcinoma (OPSCC), the overall survival in patients who underwent surgery first followed by subsequent radiation therapy (RT) was better than that in patients who needed salvage surgery after RT treatment (P = 0.0096, hazard ratio = 1.464, 95% confidence interval [CI] = 1.097 to 1.954)
The incidence of second primary tumors was significantly higher in the cohort of patients who underwent surgery only for OPSCC treatment and this difference was observed for both early and advanced stages of the disease
Summary
Since most oropharyngeal carcinomas are locally advanced at presentation, patients are often treated with radiation therapy and/or chemotherapy. Head and neck squamous cell carcinoma is the sixth most common malignancy worldwide, with the oropharynx being the third most commonly affected site. The incidence of oropharyngeal squamous cell carcinoma (OPSCC), likely developing secondary to HPV infection, has increased dramatically.[3,4]At least 70% of OPSCCs in the U.S in recent years are thought to be caused by HPV infection, compared to 16.3% in 1984–1989, and fewer than 10% currently in less economically developed countries [3,5]. OPSCC presents with odynophagia, otalgia, bleeding, trismus, and constitutional complaints of weight loss, night sweats, and weakness. It predominantly occurs in males, with a male-to-female incidence ratio ranging from 3:1 to 4:1, and presents in the fifth decade of life or later [1, 2]
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