Upfront Surgery vs. Primary Chemoradiation in an Unselected, Bicentric Patient Cohort with Oropharyngeal Squamous Cell Carcinoma—A Matched-Pair Analysis
The two pillars of therapy for oropharyngeal squamous cell carcinoma (OPSCC) are upfront surgery and primary chemoradiotherapy. Substantial regional preferences exist with regard to the selection of treatment. Despite new therapeutic approaches, patient survival remains poor, with an approximate ove...
Guardado en:
| Autores principales: | , , , , , , , , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
MDPI AG
2021
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/5ae0a5200d4941c6b90f40fb163a3e2c |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:5ae0a5200d4941c6b90f40fb163a3e2c |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:5ae0a5200d4941c6b90f40fb163a3e2c2021-11-11T15:26:40ZUpfront Surgery vs. Primary Chemoradiation in an Unselected, Bicentric Patient Cohort with Oropharyngeal Squamous Cell Carcinoma—A Matched-Pair Analysis10.3390/cancers132152652072-6694https://doaj.org/article/5ae0a5200d4941c6b90f40fb163a3e2c2021-10-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/21/5265https://doaj.org/toc/2072-6694The two pillars of therapy for oropharyngeal squamous cell carcinoma (OPSCC) are upfront surgery and primary chemoradiotherapy. Substantial regional preferences exist with regard to the selection of treatment. Despite new therapeutic approaches, patient survival remains poor, with an approximate overall survival (OS) rate of 50% at five years. This study was conducted to investigate a potential survival benefit depending on the treatment modality in OPSCC patients. We retrospectively collected data of 853 patients with histologically confirmed OPSCC from the Giessen and Maastricht cancer databases. To identify risk factors affecting survival, a Cox-proportional hazard model was applied to 442 patients with complete data sets. Based on this cohort a matched-pair analysis with 158 patients was performed to compare OS rates of patients treated either with upfront surgery or primary chemoradiation. For the collective cohort, patients treated with upfront surgery had significantly improved OS rates compared to patients treated with primary chemoradiation. In the matched-pair analysis adjusted for patients’ T-, N- and HPV-status as well as risk profile, we observed that both treatment approaches offered equivalent OS rates. Our study emphasizes that treatment recommendations should be made whenever possible on the basis of side-effect profiles caused by the therapeutic approach used. To draw further conclusions, results of the ongoing “best of” (NCT2984410) study are eagerly awaited, investigating the functional outcome after treatment of OPSCC patients.Philipp H. ZimmermannMarijn StuutNora WuerdemannKathrin MöllenhoffMalte SuchanHans EckelPhilipp WolberShachi J. SharmaFabian KämmererChristine LangerClaus WittekindtSteffen WagnerBernd KremerErnst Jan M. SpeelJens P. KlussmannMDPI AGarticleoropharyngeal squamous cell carcinomatherapyupfront surgeryprimary chemoradiationmatched-pair analysissurvivalNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5265, p 5265 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
oropharyngeal squamous cell carcinoma therapy upfront surgery primary chemoradiation matched-pair analysis survival Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 |
| spellingShingle |
oropharyngeal squamous cell carcinoma therapy upfront surgery primary chemoradiation matched-pair analysis survival Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Philipp H. Zimmermann Marijn Stuut Nora Wuerdemann Kathrin Möllenhoff Malte Suchan Hans Eckel Philipp Wolber Shachi J. Sharma Fabian Kämmerer Christine Langer Claus Wittekindt Steffen Wagner Bernd Kremer Ernst Jan M. Speel Jens P. Klussmann Upfront Surgery vs. Primary Chemoradiation in an Unselected, Bicentric Patient Cohort with Oropharyngeal Squamous Cell Carcinoma—A Matched-Pair Analysis |
| description |
The two pillars of therapy for oropharyngeal squamous cell carcinoma (OPSCC) are upfront surgery and primary chemoradiotherapy. Substantial regional preferences exist with regard to the selection of treatment. Despite new therapeutic approaches, patient survival remains poor, with an approximate overall survival (OS) rate of 50% at five years. This study was conducted to investigate a potential survival benefit depending on the treatment modality in OPSCC patients. We retrospectively collected data of 853 patients with histologically confirmed OPSCC from the Giessen and Maastricht cancer databases. To identify risk factors affecting survival, a Cox-proportional hazard model was applied to 442 patients with complete data sets. Based on this cohort a matched-pair analysis with 158 patients was performed to compare OS rates of patients treated either with upfront surgery or primary chemoradiation. For the collective cohort, patients treated with upfront surgery had significantly improved OS rates compared to patients treated with primary chemoradiation. In the matched-pair analysis adjusted for patients’ T-, N- and HPV-status as well as risk profile, we observed that both treatment approaches offered equivalent OS rates. Our study emphasizes that treatment recommendations should be made whenever possible on the basis of side-effect profiles caused by the therapeutic approach used. To draw further conclusions, results of the ongoing “best of” (NCT2984410) study are eagerly awaited, investigating the functional outcome after treatment of OPSCC patients. |
| format |
article |
| author |
Philipp H. Zimmermann Marijn Stuut Nora Wuerdemann Kathrin Möllenhoff Malte Suchan Hans Eckel Philipp Wolber Shachi J. Sharma Fabian Kämmerer Christine Langer Claus Wittekindt Steffen Wagner Bernd Kremer Ernst Jan M. Speel Jens P. Klussmann |
| author_facet |
Philipp H. Zimmermann Marijn Stuut Nora Wuerdemann Kathrin Möllenhoff Malte Suchan Hans Eckel Philipp Wolber Shachi J. Sharma Fabian Kämmerer Christine Langer Claus Wittekindt Steffen Wagner Bernd Kremer Ernst Jan M. Speel Jens P. Klussmann |
| author_sort |
Philipp H. Zimmermann |
| title |
Upfront Surgery vs. Primary Chemoradiation in an Unselected, Bicentric Patient Cohort with Oropharyngeal Squamous Cell Carcinoma—A Matched-Pair Analysis |
| title_short |
Upfront Surgery vs. Primary Chemoradiation in an Unselected, Bicentric Patient Cohort with Oropharyngeal Squamous Cell Carcinoma—A Matched-Pair Analysis |
| title_full |
Upfront Surgery vs. Primary Chemoradiation in an Unselected, Bicentric Patient Cohort with Oropharyngeal Squamous Cell Carcinoma—A Matched-Pair Analysis |
| title_fullStr |
Upfront Surgery vs. Primary Chemoradiation in an Unselected, Bicentric Patient Cohort with Oropharyngeal Squamous Cell Carcinoma—A Matched-Pair Analysis |
| title_full_unstemmed |
Upfront Surgery vs. Primary Chemoradiation in an Unselected, Bicentric Patient Cohort with Oropharyngeal Squamous Cell Carcinoma—A Matched-Pair Analysis |
| title_sort |
upfront surgery vs. primary chemoradiation in an unselected, bicentric patient cohort with oropharyngeal squamous cell carcinoma—a matched-pair analysis |
| publisher |
MDPI AG |
| publishDate |
2021 |
| url |
https://doaj.org/article/5ae0a5200d4941c6b90f40fb163a3e2c |
| work_keys_str_mv |
AT philipphzimmermann upfrontsurgeryvsprimarychemoradiationinanunselectedbicentricpatientcohortwithoropharyngealsquamouscellcarcinomaamatchedpairanalysis AT marijnstuut upfrontsurgeryvsprimarychemoradiationinanunselectedbicentricpatientcohortwithoropharyngealsquamouscellcarcinomaamatchedpairanalysis AT norawuerdemann upfrontsurgeryvsprimarychemoradiationinanunselectedbicentricpatientcohortwithoropharyngealsquamouscellcarcinomaamatchedpairanalysis AT kathrinmollenhoff upfrontsurgeryvsprimarychemoradiationinanunselectedbicentricpatientcohortwithoropharyngealsquamouscellcarcinomaamatchedpairanalysis AT maltesuchan upfrontsurgeryvsprimarychemoradiationinanunselectedbicentricpatientcohortwithoropharyngealsquamouscellcarcinomaamatchedpairanalysis AT hanseckel upfrontsurgeryvsprimarychemoradiationinanunselectedbicentricpatientcohortwithoropharyngealsquamouscellcarcinomaamatchedpairanalysis AT philippwolber upfrontsurgeryvsprimarychemoradiationinanunselectedbicentricpatientcohortwithoropharyngealsquamouscellcarcinomaamatchedpairanalysis AT shachijsharma upfrontsurgeryvsprimarychemoradiationinanunselectedbicentricpatientcohortwithoropharyngealsquamouscellcarcinomaamatchedpairanalysis AT fabiankammerer upfrontsurgeryvsprimarychemoradiationinanunselectedbicentricpatientcohortwithoropharyngealsquamouscellcarcinomaamatchedpairanalysis AT christinelanger upfrontsurgeryvsprimarychemoradiationinanunselectedbicentricpatientcohortwithoropharyngealsquamouscellcarcinomaamatchedpairanalysis AT clauswittekindt upfrontsurgeryvsprimarychemoradiationinanunselectedbicentricpatientcohortwithoropharyngealsquamouscellcarcinomaamatchedpairanalysis AT steffenwagner upfrontsurgeryvsprimarychemoradiationinanunselectedbicentricpatientcohortwithoropharyngealsquamouscellcarcinomaamatchedpairanalysis AT berndkremer upfrontsurgeryvsprimarychemoradiationinanunselectedbicentricpatientcohortwithoropharyngealsquamouscellcarcinomaamatchedpairanalysis AT ernstjanmspeel upfrontsurgeryvsprimarychemoradiationinanunselectedbicentricpatientcohortwithoropharyngealsquamouscellcarcinomaamatchedpairanalysis AT jenspklussmann upfrontsurgeryvsprimarychemoradiationinanunselectedbicentricpatientcohortwithoropharyngealsquamouscellcarcinomaamatchedpairanalysis |
| _version_ |
1718435309789642752 |