{Reference Type}: Journal Article
{Title}: Ten-Year Efficacy of Transoral Surgery for Squamous Carcinoma of the Lateral Oropharynx.
{Author}: Laccourreye O;Garcia D;Rahman A;Holsinger FC;
{Journal}: Laryngoscope
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jun 25
{Factor}: 2.97
{DOI}: 10.1002/lary.31574
{Abstract}: <B>OBJECTIVE: </B>To document the 10-year results of transoral mandibular preservation surgery for patients with T1-2 squamous cell carcinoma (SCC) arising from the lateral oropharynx.<BR><B>METHODS: </B>This was a retrospective 30-year review using STROBE guidelines at an academic, tertiary referral center. A total of 294 patients with T1-2 SCC of the lateral oropharynx were reviewed. Only 19% of patients were never-smokers, suggesting a predominantly HPV-negative population. All patients had transoral mandibular preservation surgery. Follow-up therapy included neck dissection (76.5%), induction chemotherapy (57.8%), and postoperative radiation therapy (31.6%) Local control, survival, and functional endpoints, as well as the consequences of local recurrence, were analyzed.<BR><B>RESULTS: </B>The 10-year local disease control was 88.3%. Local recurrence was salvaged in 50% of cases, resulting in an overall 94.5% local control rate. The overall 10-year survival was 50%. Mortality was related to metachronous second primary cancer (MSPC) (29.2%), medical comorbidities (25.7%), uncontrolled local recurrence (10%), and complications following transoral resection (4.2%). In multivariate analysis, the development of an MSPC significantly increased (p < 0.005) the risk of death. Overall, 95.2% of patients achieved mandibular preservation. However, gastrostomy and tracheostomy dependence occurred in 1% and 0.3% of cases, respectively.<BR><B>CONCLUSIONS: </B>For a patient population with a significant percentage of tobacco-associated oropharyngeal cancer (OPC), transoral surgery was associated with long-term minimal postoperative complications and a high rate of local control. MSPC was the main cause of death during the first 10 postoperative years. Such long-term figures support transoral surgery as an effective first-line treatment for early-stage predominantly tobacco-related OPC.<BR><B>METHODS: </B>4 Laryngoscope, 2024.