A benchmark for oncologic outcomes and model for lethal recurrence risk after transoral robotic resection of HPV-related oropharyngeal cancers.
A benchmark for oncologic outcomes and model for lethal recurrence risk after transoral robotic resection of HPV-related oropharyngeal cancers.
复制标题
经口机器人切除HPV相关口咽癌后肿瘤学结局的基准和致命复发风险模型
DOI：
10.1016/j.oraloncology.2022.105798
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发表时间：
2022-04
期刊：
影响因子：
4.8
通讯作者：
Basu, Devraj
中科院分区：
文献类型：
--
作者：
Brody, Robert M.;Shimunov, David;Cohen, Roger B.;Lin, Alexander;Lukens, John N.;Hartner, Lee;Aggarwal, Charu;Duvvuri, Umamaheswar;Montone, Kathleen T.;Jalaly, Jalal B.;LiVolsi, Virginia A.;Carey, Ryan M.;Shanti, Rabie M.;Rajasekaran, Karthik;Chalian, Ara A.;Rassekh, Christopher H.;Cannady, Steven B.;Newman, Jason G.;O'Malley, Bert W.;Weinstein, Gregory S.;Gimotty, Phyllis A.;Basu, Devraj
关键词：
越来越多的口腔机器人手术(TORS)的使用可能会影响HPV阳性口咽鳞状细胞癌(OPSCCs)的预后。我们的目标是描述TRS后大型HPV+OPSCC队列的肿瘤学结果，并在该治疗范例下开发复发风险预测模型。对在同一机构接受基于TORS治疗的634名HPV+OPSCC患者进行了回顾，以描述整个队列中的存活情况以及复发患者的情况。采用病例对照亚群的多变量Logistic回归分析，对远处转移复发(DMR)和局部复发(LRR)的风险进行建模。5年总生存率和无复发生存率分别为91.2%和86.1%。DMR组和单纯LRR组的5年总生存率分别为52.5%和83.3%(P=0.01)。在病例对照分析中，在早期临床疾病患者中，手术切缘阳性与DMR相关(调整后OR 5.8，CI 2.1-16.0，P=.001)，但不与孤立的LRR相关，并使DMR风险增加4.2倍。相比之下，LRR与没有接受推荐的辅助治疗有关(OR 13.4，CI 6.3-28.5，P<；.001)。这项研究为基于Tors的治疗后HPV+OPSCC的肿瘤学结果设定了一个基准。在这种治疗模式下，在临床试验设计和治疗后监测期间，边际与评估致死性复发风险相关。
Increasing use of transoral robotic surgery (TORS) is likely to impact outcomes for HPV+ oropharyngeal squamous cell carcinomas (OPSCCs). We aimed to describe oncologic outcomes for a large HPV+ OPSCC cohort after TORS and develop a risk prediction model for recurrence under this treatment paradigm. 634 HPV+ OPSCC patients receiving TORS-based therapy at a single institution were reviewed retrospectively to describe survival across the entire cohort and for patients suffering recurrence. Risks for distant metastatic recurrence (DMR) and locoregional recurrence (LRR) were modeled using multivariate logistic regression analyses of case-control sub-cohorts. 5-year overall and recurrence-free survival were 91.2% and 86.1%, respectively. 5-year overall survival was 52.5% following DMR and 83.3% after isolated LRR (P=.01). In case-control analyses, positive surgical margins were associated with DMR (adjusted OR 5.8, CI 2.1–16.0, P=.001), but not isolated LRR, and increased DMR risk 4.2 fold in patients with early clinical stage disease. By contrast, LRR was associated with not receiving recommended adjuvant therapy (OR 13.4, CI 6.3–28.5, P<.001). This study sets a benchmark for oncologic outcomes from HPV+ OPSCC after TORS-based therapy. Under this treatment paradigm, margins are relevant for assessing lethal recurrence risk during clinical trial design and post-treatment surveillance.
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影响因子：
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作者：
Eisenhauer, E. A.;Therasse, P.;Verweij, J.
通讯作者：
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Cracchiolo JR;Baxi SS;Morris LG;Ganly I;Patel SG;Cohen MA;Roman BR
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通讯作者：
Dunn, Janet
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作者：
Harbison, R. Alex;Kubik, Mark;Mendez, Eduardo
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