P16/HPV-negative oropharyngeal squamous cell carcinoma survival: Comparing primary surgery to primary chemoradiotherapy. A systematic review and meta-analysis
Bianca Maria Festa , Nancy Schaefer , William Reschly , William M. Mendenhall , Dustin Conrad , Krishna Hanubal , Mohamed Shama , Carolyn O. Dirain , Brian Hughley , Deepa Danan , Peter T. Dziegielewski
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引用次数: 0
Abstract
Objectives
This study investigated differences in survival for p16/HPV-negative OPSCC patients treated with primary surgery versus primary (chemo-)radiation therapy (CRT).
Materials and methods
PubMed, CINAHL and Web of Science databases and the online Cochrane Library were searched for relevant English language studies describing the survival outcomes of p16/HPV-negative OPSCC patients treated with primary surgery or primary CRT. The primary endpoint was the 5-year OS; the secondary endpoints included 5-year DSS and DFS, and 3- and 2-year OS, DSS and DFS. The pooled survival curves were estimated using a distribution-free approach assuming random effects. Cumulative KM curves for OS, DSS and DFS were built for each treatment group.
Results
Twenty-two publications were included in the final analysis. Patients included (n = 1903) were divided according to treatment (“surgery” group, n = 942; “RT/CRT” group, n = 961). For all the endpoints, surgery demonstrated improved short- and long-term survival compared to RT/CRT, although selection bias may have impacted the outcomes. The estimated pooled 5-year OS for the surgery and the RT/CRT group was 54.1 % (95 % CI: 44.4%–65.9 %) and 45.7 % (95 % CI: 41.8%–49.9 %), respectively.
Conclusion
Primary surgery and primary CRT for p16/HPV-negative OPSCC both provide acceptable survival outcomes, although in many cases surgery has shown improved survival rates. Further research should focus on when each treatment modality should be used to achieve the goals of treatment completion, survival and functional outcomes.
期刊介绍:
JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery.
The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.