Impact of surgical margins on local control in patients undergoing single-modality transoral robotic surgery for HPV-related oropharyngeal squamous cell carcinoma

Andrew J. Holcomb, Matthew Herberg, Madeleine Strohl, Edgar Ochoa, Allen L. Feng, Nicholas B. Abt, Tara E. Mokhtari, Krish Suresh, Christopher I. McHugh, Anuraag S. Parikh, Peter Sadow, William Faquin, Daniel Faden, Daniel G. Deschler, Mark A. Varvares, Derrick T. Lin, Carole Fakhry, William R. Ryan, Jeremy D Richmon

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The impact of close surgical margins on oncologic outcomes in HPV-related oropharyngeal squamous cell carcinoma (HPV + OPSCC) is unclear. Methods: Retrospective case series including patients undergoing single modality transoral robotic surgery (TORS) for HPV + OPSCC at three academic medical centers from 2010 to 2019. Outcomes were compared between patients with close surgical margins (<1 mm or requiring re-resection) and clear margins using the Kaplan–Meier method. Results: Ninety-nine patients were included (median follow-up 21 months, range 6–121). Final margins were close in 22 (22.2%) patients, clear in 75 (75.8%), and positive in two (2.0%). Eight patients (8.1%) recurred, including two local recurrences (2.0%). Four patients died during the study period (4.0%). Local control (p = 0.470), disease-free survival (p = 0.513), and overall survival (p = 0.064) did not differ between patients with close and clear margins. Conclusions: Patients with close surgical margins after TORS for HPV + OPSCC without concurrent indications for adjuvant therapy may be considered for observation alone.

Original languageEnglish (US)
Pages (from-to)2434-2444
Number of pages11
JournalHead and Neck
Volume43
Issue number8
DOIs
StatePublished - Aug 2021

Keywords

  • human papillomavirus
  • oropharynx
  • squamous cell carcinoma
  • surgical margins
  • transoral robotic surgery

ASJC Scopus subject areas

  • Otorhinolaryngology

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