Primary Transoral Surgery Yields Good Swallowing Outcomes Despite Increased Risk of Death in HPV-related OPSCC
Author: Hayley Virgil Source: www.cancernetwork.com Despite an increased risk of grade 5 toxicities, patients with human papillomavirus–related oropharyngeal squamous cell carcinoma who received primary transoral surgery and neck dissection vs radiotherapy experienced good swallowing outcomes at 1 year. Good swallowing outcomes were observed at 1 year among patients with human papillomavirus (HPV)–related oropharyngeal squamous cell carcinoma who were treated with primary transoral surgery (TOS) and neck dissection vs radiotherapy despite an increased risk of developing grade 5 toxicities, according to findings from the phase 2 ORATOR2 trial (NCT03210103). At a median follow up of 17 months, investigators reported 3 deaths in both the TOS and neck dissection arm, 2 of which were treatment related and 1 due to myocardial infarction at 8.5 months. The 2 treatment-related deaths were reported following TORS and were due to oropharyngeal hemorrhage and cervical vertebral osteomyelitis. Moreover, investigators reported 4 progression-free survival (PFS) events in this arm, 3 of which were mortality events and 1 due to local recurrence. As such, overall survival (OS) and PFS data were considered immature at the time of study. In total, 67% of patients in the radiotherapy arm and 71% in the TOS and neck dissection arm experienced grade 2 to 5 toxic effects. The study included patients who were 18 years or older with T1 to T2 disease and N0 to N2 staging. Those who enrolled were randomized 1:1 to either the primary radiotherapy group, including 60 Gys followed by concurrent weekly cisplatin chemotherapy at 40 mg/m2 in [...]