The impact of delayed adjuvant therapy in patients with HPV associated oropharyngeal cancer

Background:

The standard therapy of HPV associated oropharyngeal squamous cell carcinoma (OPSCC) after primary surgery is usually a risk adapted and timely adjuvant treatment with radiotherapy or radiochemotherapy.

The aim of this study is to evaluate the impact of delayed adjuvant therapy on the prognosis of patients with HPV associated OPSCC.

Methods:

Retrospective analysis of the medical charts of patients with HPV associated OPSCC treated by surgery and adjuvant treatment at a tertiary academic cancer center from 2000 to 2016. Patients were subdivided depending on the implementation of adjuvant treatment within or after 50 days following primary surgical treatment. Primary endpoint was the recurrence rate, rate of distant metastases as well as the overall survival (OS).

Results:

The medical charts of 157 patients were retrospectively evaluated. Adjuvant treatment began within 50 days (average: 38.8 days ± 8.3 SD) in 78 cases compared to 79 cases after 50 days (average: 71.5 ± 19.5 SD) in following primary surgery. The mean follow-up time was 57.6 month (SD = 42). Patients' demographic characteristics and oncologic parameters, e.g. tumorstage (p = 0.787), resection status (p = 0.139), extranodal extension (p = 0.645), radiation dose (p = 0.148), were similarly distributed in both groups. Five year OS was 85.7% and 87.4% (p = 0.588), while the rates of local and regional recurrence were 3.8% and 6.4% (p = 0.455) and of distant metastases; 5.1% and 9% (p = 0.369) implementing adjuvant treatment within or later than 50 days, respectively.

Conclusion:

An adjuvant therapy initiated over 50 days after primary surgical tumor removal may still be effective in patients with HPV associated OPSCC without compromising the oncologic outcomes.

Publication History

Publication Date:
23 April 2019 (online)