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Overall survival, disease-free survival and quality of life in patients affected by HPV mediated p16+ oropharyngeal squamous cell carcinoma treated with upfront trans-oral robotic surgery vs radiotherapy or chemoradiotherapy

  • Head and Neck
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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Treatment de-intensification for p16 + oropharyngeal squamous cell carcinoma (OPSCC) is an area of active research to reduce the side effects and improve patients’ quality of life (QoL). In this paper we evaluated the Overall Survival (OS), the Disease-Free Survival (DFS) and the QoL of patients affected by p16 + OPSCC according to their prognostic stage group (PSG) and different treatments.

Methods

Patients were selected retrospectively through our Electronic Tumor Board Database according to prespecified inclusion criteria. Basic data of eligible patients were recorded and analyzed. Then, OS and DFS were evaluated according to the PSG and the treatments performed. Patients alive completed three questionnaires: the QoL Questionnaire Core 30 (QLQ-C30), the QoL Questionnaire Head & Neck 43 (QLQ-HN43) and the MD Anderson Dysphagia Inventory (MDADI) questionnaire.

Results

Sixty-one patients were included in this study. Eight patients died from the disease and the remaining 53 patients completed the 3 questionnaires. Fifteen (25%) patients were treated with upfront surgery, 6 (10%) patients with definitive radiotherapy and 40 (65%) patients with concomitant chemoradiotherapy. Comparing the DFS and the OS of PSG I patients by the different treatments performed, no statistically significant difference was identified. Patients treated with upfront surgery showed better outcomes in some aspects of their QoL.

Conclusion

For p16 + OPSCC PSG I patients, upfront surgery can be considered a valid alternative to radiotherapy or chemoradiotherapy while maintaining a comparable DFS and OS and giving patients better results in terms of specific aspects of their QoL.

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Data availability

The data that support the findings of this study are available on request from the corresponding author, GF.

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Funding

The authors declare no funding received.

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Authors and Affiliations

  1. Otolaryngology, Audiology and Phoniatric Operative Unit, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, Azienda Ospedaliero-Universitaria Pisana (AOUP), University of Pisa, Via Paradisa, 2, 56124, Pisa, Italy

    Giacomo Fiacchini, Miriana Picariello, Iacopo Dallan, Augusto Pietro Casani, Stefano Berrettini & Luca Bruschini

  2. Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy

    Domenico Tricò

  3. Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova - Azienda Ospedale-Università di Padova, Pisa, Italy

    Federica Amato

  4. Department of Radiation Oncology, University of Pisa, Pisa, Italy

    Fabiola Paiar & Stefano Ursino

Authors
  1. Giacomo Fiacchini
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  2. Miriana Picariello
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  3. Iacopo Dallan
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  4. Domenico Tricò
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  5. Augusto Pietro Casani
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  7. Fabiola Paiar
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  8. Stefano Ursino
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  9. Stefano Berrettini
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  10. Luca Bruschini
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by GF, MP and FA. The first draft of the manuscript was written by GF and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Giacomo Fiacchini.

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The authors declare no conflicts of interest/competing interests.

Ethical approval

This study was approved by our local Ethics committee and adhered to the principles outlined in the Declaration of Helsinki.

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Written informed consent was obtained from all participants.

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Fiacchini, G., Picariello, M., Dallan, I. et al. Overall survival, disease-free survival and quality of life in patients affected by HPV mediated p16+ oropharyngeal squamous cell carcinoma treated with upfront trans-oral robotic surgery vs radiotherapy or chemoradiotherapy. Eur Arch Otorhinolaryngol 281, 1913–1921 (2024). https://doi.org/10.1007/s00405-023-08432-9

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