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Late-Breaking Scientific Oral Presentations

Head and Neck Surgery

Session: Late-Breaking Scientific Orals: Head and Neck Surgery

Surgical Versus Nonsurgical Treatment of Advanced-Stage Oropharyngeal Squamous Cell Carcinoma: A Systematic Review and Meta-analysis

Sunday, September 29, 2024
4:18 PM – 4:24 PM EDT
Location: MBCC, 222
Disclosure(s):
Megan K. Scharner, RN:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

W. Greer G. Albergotti, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Though oropharyngeal squamous cell carcinoma (OPSCC) often presents in advanced stages, there is little consensus on the ideal primary treatment modality. The purpose of this systematic review and meta-analysis is to compare the survival outcomes of surgical versus non-surgical primary treatment of advanced-stage OPSCC.

Methods: CINAHL, Cochrane Library, PubMed, and Scopus databases were searched from inception through February 29, 2024. Studies directly comparing survival and complication outcomes of patients with advanced OPSCC treated by primary surgery (+/- adjuvant therapy) or primary nonsurgical therapy were selected for inclusion. Meta-analyses hazard ratio (HR) and proportions (%) were performed for the outcomes of 2-year, 3-year, and 5-year overall survival (OS), disease-free survival (DFS), disease-specific survival (DSS), and relapse-free survival (RFS).

Results: A total of 44 studies reporting on (N = 35,681) patients with OPSCC were included for meta-analysis, with a mean age of 58.9 (range 13 to 96.5). There were 77.2% males and 22% females. Of the included patients, 89.6% (95% CI 83.6-94.3) had advanced staged (III/IV) OPSCC. In the advanced stage group, primary treatment with surgery and adjuvant chemoradiotherapy (CRT) demonstrated the best 5-year overall survival, at 67.1% (95% CI 55.6-77.6), and 5-year disease specific survival, at 77.5% (95% CI 66.2-87.1). Survival outcomes were in favor of surgical + CRT as compared to radiation only: 2-year OS (HR = 0.29, 95% CI 0.19-0.38, p < 0.01), 3-year OS (HR = 0.7, 95% CI 0.03-0.19, p < 0.00001) and 5-year OS (HR = 0.07, 95% CI 0.02-0.22, p < 0.001).

Conclusions: This study suggests that surgical treatment with adjuvant CRT could offer better overall survival outcomes compared with non-surgical treatment. Further research is needed to determine superior treatment modalities in OPSCC subgroups, such as HPV+ tumors.

    Presenting Author(s)

  • Megan K. Scharner, RN

    Medical Student
    Medical University of South Carolina College of Medicine
    Charleston, SC, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • JO

    Johnny M. Owen, III

    Medical University of South Carolina College of Medicine, South Carolina, United States

    Disclosure information not submitted.

  • SN

    Shaun A. Nguyen, MD

    Clinical Research Director
    Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
    Charleston, South Carolina, United States

    Disclosure information not submitted.

  • Alexandra E. Kejner, MD

    Associate Professor of Head and Neck Surgical Oncology/Microvascular Reconstruction
    Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
    Charleston, SC, United States

    Disclosure information not submitted.

  • WA

    W. Greer Albergotti, MD

    Associate Professor
    Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
    Charleston, South Carolina, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • JN

    Jason G. Newman, MD

    Professor
    Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
    Mount Pleasant, SC, United States

    Disclosure information not submitted.