Multi-institutional analysis of outcomes following transoral surgery for HPV-positive oropharyngeal squamous cell carcinoma in elderly patients

Ryan S. Jackson; Stephanie Chen; Aisling Last; Amish Khan; Dorina Kallogjeri; Kathryn M. Van Abel; Eric J. Moore; Patrik Pipkorn

doi:10.1002/hed.25946

Multi-institutional analysis of outcomes following transoral surgery for HPV-positive oropharyngeal squamous cell carcinoma in elderly patients

Ryan S. Jackson, Stephanie Chen, Aisling Last, Amish Khan, Dorina Kallogjeri, Kathryn M. Van Abel, Eric J. Moore, Patrik Pipkorn

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

Abstract

Background: The incidence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) is rising, even in elderly patients. The outcomes of transoral surgery (TOS) in this population are not entirely known. Methods: A retrospective review was performed at two institutions from October 2003 to September 2016 on patients 70 years or older with HPV-related OPSCC treated with TOS. Results: A total of 75 patients were included with a mean age of 74 years (70-87 years). At a median follow-up of 35.7 months, 3-year overall survival was 81.5% and disease-specific survival was 94.3%. Advanced cT stage (odds ratio, 2.74; 95% confidence interval, 1.13-6.64) negatively impacted OS. Conjunctive consolidation was performed to create a staging system with patients older than 80 years, severe comorbidity, and cT3-4 having worse survival. Conclusions: Elderly patients with HPV-related OPSCC treated with TOS have excellent survival and therefore should not be excluded from such therapy based on age alone.

Original language	English
Pages (from-to)	3933-3939
Number of pages	7
Journal	Head and Neck
Volume	41
Issue number	11
DOIs	https://doi.org/10.1002/hed.25946
State	Published - Nov 1 2019

Keywords

elderly
head and neck cancer
human papillomavirus
oropharyngeal cancer
transoral surgery

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title = "Multi-institutional analysis of outcomes following transoral surgery for HPV-positive oropharyngeal squamous cell carcinoma in elderly patients",

abstract = "Background: The incidence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) is rising, even in elderly patients. The outcomes of transoral surgery (TOS) in this population are not entirely known. Methods: A retrospective review was performed at two institutions from October 2003 to September 2016 on patients 70 years or older with HPV-related OPSCC treated with TOS. Results: A total of 75 patients were included with a mean age of 74 years (70-87 years). At a median follow-up of 35.7 months, 3-year overall survival was 81.5% and disease-specific survival was 94.3%. Advanced cT stage (odds ratio, 2.74; 95% confidence interval, 1.13-6.64) negatively impacted OS. Conjunctive consolidation was performed to create a staging system with patients older than 80 years, severe comorbidity, and cT3-4 having worse survival. Conclusions: Elderly patients with HPV-related OPSCC treated with TOS have excellent survival and therefore should not be excluded from such therapy based on age alone.",

keywords = "elderly, head and neck cancer, human papillomavirus, oropharyngeal cancer, transoral surgery",

author = "Jackson, {Ryan S.} and Stephanie Chen and Aisling Last and Amish Khan and Dorina Kallogjeri and {Van Abel}, {Kathryn M.} and Moore, {Eric J.} and Patrik Pipkorn",

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doi = "10.1002/hed.25946",

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AU - Jackson, Ryan S.

AU - Chen, Stephanie

AU - Last, Aisling

AU - Khan, Amish

AU - Kallogjeri, Dorina

AU - Van Abel, Kathryn M.

AU - Moore, Eric J.

AU - Pipkorn, Patrik

PY - 2019/11/1

Y1 - 2019/11/1

N2 - Background: The incidence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) is rising, even in elderly patients. The outcomes of transoral surgery (TOS) in this population are not entirely known. Methods: A retrospective review was performed at two institutions from October 2003 to September 2016 on patients 70 years or older with HPV-related OPSCC treated with TOS. Results: A total of 75 patients were included with a mean age of 74 years (70-87 years). At a median follow-up of 35.7 months, 3-year overall survival was 81.5% and disease-specific survival was 94.3%. Advanced cT stage (odds ratio, 2.74; 95% confidence interval, 1.13-6.64) negatively impacted OS. Conjunctive consolidation was performed to create a staging system with patients older than 80 years, severe comorbidity, and cT3-4 having worse survival. Conclusions: Elderly patients with HPV-related OPSCC treated with TOS have excellent survival and therefore should not be excluded from such therapy based on age alone.

AB - Background: The incidence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) is rising, even in elderly patients. The outcomes of transoral surgery (TOS) in this population are not entirely known. Methods: A retrospective review was performed at two institutions from October 2003 to September 2016 on patients 70 years or older with HPV-related OPSCC treated with TOS. Results: A total of 75 patients were included with a mean age of 74 years (70-87 years). At a median follow-up of 35.7 months, 3-year overall survival was 81.5% and disease-specific survival was 94.3%. Advanced cT stage (odds ratio, 2.74; 95% confidence interval, 1.13-6.64) negatively impacted OS. Conjunctive consolidation was performed to create a staging system with patients older than 80 years, severe comorbidity, and cT3-4 having worse survival. Conclusions: Elderly patients with HPV-related OPSCC treated with TOS have excellent survival and therefore should not be excluded from such therapy based on age alone.

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KW - human papillomavirus

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Multi-institutional analysis of outcomes following transoral surgery for HPV-positive oropharyngeal squamous cell carcinoma in elderly patients

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