Upfront surgery or definitive radiotherapy for p16+ oropharyngeal cancer. A GETTEC multicentric study

Creators: Culié, Dorian; Schiappa, Renaud; Modesto, Anouchka; Viotti, Julien; Chamorey, Emmanuel; Dassonville, Olivier; Poissonnet, Gilles; Bizeau, Alain; Vergez, Sebastien; Dupret-Bories, Agnes; Fakhry, Nicolas; Santini, Laure; Lallemant, Benjamin; Chambon, Guillaume; Sudaka, Anne; Peyrade, Frederic; Saada-Bouzid, Esma; Benezery, Karen; Jourdan-Soulier, Florence; Chapel, Françoise; Ramay, Anne Sophie; Roger, Pascal; Galissier, Thibault; Coste, Valérie; Ben Lakdar, Aicha; Guerlain, Joanne; Mirghani, Haitham; Gorphe, Phillipe; Guelfucci, Bruno; Garrel, Renaud; Temam, Stephane; Bozec, Alexandre

Others:: Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL) ; UNICANCER-Université Côte d'Azur (UCA); Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037) ; Université Toulouse III - Paul Sabatier (UT3) ; Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM); Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer - Hôpital Sainte-Musse; Assistance Publique - Hôpitaux de Marseille (APHM); Centre Hospitalier Universitaire de Nîmes (CHU Nîmes); Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM) ; CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM); Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier); Pathogenesis and Control of Chronic and Emerging Infections (PCCEI) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université des Antilles (UA)-Etablissement français du don du sang [Montpellier]; Institut Gustave Roussy (IGR); Département de cancérologie cervico-faciale [Gustave Roussy] (CCF) ; Institut Gustave Roussy (IGR); Hôpital Européen Georges Pompidou [APHP] (HEGP) ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO); Université de Montpellier (UM)

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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.

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Upfront surgery or definitive radiotherapy for p16+ oropharyngeal cancer. A GETTEC multicentric study

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