Upfront surgery or definitive radiotherapy for p16+ oropharyngeal cancer. A GETTEC multicentric study
Menée auprès de 382 patients atteints d'un cancer de l'oropharynx lié au papillomavirus humain et pris en charge entre 2009 et 2014, cette étude multicentrique compare l'efficacité, du point de vue de la survie globale, de la survie spécifique et de la survie sans récidive, d'une stratégie thérapeutique comportant une chirurgie avec ou sans radiothérapie suivie d'une chimiothérapie adjuvante, et d'un traitement par radiothérapie en combinaison ou non avec une chimiothérapie
Background: The aim of this study was to assess the impact of the initial therapeutic strategy on oncologic outcomes in patients with HPV-positive OPSCC. Methods: All p16-positive OPSCCs treated from 2009 to 2014 in 7 centers were retrospectively included and classified according to the therapeutic strategy: surgical strategy (surgery ± adjuvant radiotherapy and chemotherapy) vs. non-surgical strategy (definitive radiotherapy ± chemotherapy). Univariate, multivariate propensity score matching analyses were performed to compare overall (OS), disease-specific (DSS) and recurrence-free survival (RFS). Results: 382 patients were included (surgical group: 144; non-surgical group: 238). Five-year OS, DSS and RFS were 89.2, 96.8 and 83.9% in the surgical group and 84.2, 87.1 and 70.4% in the non-surgical group, respectively. These differences were statistically significant for DSS and RFS after multivariate analysis, but only for RFS after propensity score matching analysis. Conclusion: In p16+ OPSCC patients, upfront surgery results in higher RFS than definitive radiotherapy ± chemotherapy but does not impact OS.