Impact of positive margins on outcomes of oropharyngeal squamous cell carcinoma according to p16 status
Impact of positive margins on outcomes of oropharyngeal squamous cell carcinoma according to p16 status
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DOI：
10.1002/hed.24824
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发表时间：
2017-08-01
影响因子：
2.9
通讯作者：
Sheahan, Patrick
中科院分区：
文献类型：
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作者：
Molony, Peter;Kharytaniuk, Natallia;Sheahan, Patrick
背景资料：目前，头颈部癌手术切缘阳性被认为是术后放化疗（CRT）优于单纯放疗（RT）的指标。然而，有较少的数据关于边缘状态对人乳头状瘤病毒（HPV）相关的口咽鳞状细胞癌（SCC）的影响。方法：我们进行了一项回顾性研究，55例口咽鳞状细胞癌接受初级手术治疗。根据p16状态研究切缘状态对疾病特异性生存期（DSS）的影响。这些病例的辅助治疗为CRT（n = 6）、单独RT（n = 14）和无（n = 1）。在p16阴性患者中，阳性切缘和切缘发育不良预测DSS显著更差。在p16阳性疾病的患者中，边缘状态对DSS.Conclusion没有影响：p16阳性口咽部鳞状细胞癌和切除后阳性边缘的患者复发风险低，尽管大多数接受单独RT作为辅助治疗。这些发现提出了关于该组术后CRT额外受益的问题。
Background: Currently, positive surgical margins in head and neck cancer are considered to be an indicator for postoperative chemoradiotherapy (CRT) over radiotherapy (RT) alone. However, there are less data regarding the impact of margin status on human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (SCC).Methods: We performed a retrospective review of 55 patients with oropharyngeal SCC undergoing primary surgical treatment. The impact of margin status on disease-specific survival (DSS) was studied according to p16 status.Results: Twenty-one patients had positive margins. Adjuvant treatment in these cases was CRT (n = 6), RT alone (n = 14), and none (n = 1). Among p16-negative patients, positive margins and dysplasia at margins predicted significantly worse DSS. Among patients with p16-positive disease, margin status had no impact on DSS.Conclusion: Patients with p16-positive oropharyngeal SCC and positive margins after excision maintain a low risk of recurrence despite most receiving RT alone as adjuvant treatment. These findings raise questions regarding the additional benefit of postoperative CRT in this group.