Allersma, Ties E. (2024) Recurrences in Oropharyngeal Cancer and the role of Salvage Surgery: A single center experience of 572 patients over a 11-year period. thesis, Medicine.
Full text available on request.Abstract
Introduction: Oropharyngeal cancer prognosis is dependent on the tumor stage and HPV status. Treatment approaches diverge according to tumor stage, favoring organ-preserving strategies like radiotherapy or chemoradiation in the Netherlands. Recurrent disease after (chemo-)radiotherapy is associated with poorer prognosis, but salvage surgery may offer a curative option. This retrospective study aims to evaluate the clinical outcomes of radiotherapy-treated oropharyngeal cancer patients and the role of salvage surgery in recurrent cases. Methods: Data from oropharyngeal cancer patients treated with radiotherapy at UMC Utrecht between 2010-2021 were analyzed for patient, tumor, and treatment characteristics. Survival analysis and time to recurrence were performed using the Kaplan-Meier method, while a Cox regression model examined the impact of selected prognosticators and survival outcomes. Results: 572 patients were included, yielding a recurrence rate of 18.2% and a median time to recurrence of 8 months. The overall median survival for the entire cohort was 60 months, with post-recurrence median survival durations of 8 months for all treatments, 23 months for salvage surgery, and 3 months for palliative treatment. Cox regression analysis revealed that significant determinants impacting overall survival included HPV status, higher primary T and N stages, recurrence site, and the stage of recurrence disease. Conclusion: Oropharyngeal cancer patients exhibit 1-, 2-, and 5-year overall survival rates of 79.8%, 70.1%, and 50.5%, respectively, with HPV-positive carcinomas showing a better prognosis. Approximately 18% of patients experience recurrence, with a median overall survival of 8 months. In selected patients, salvage surgery represents an indispensable treatment option.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Dr. Rijken, J.A. and Dr. de Ridder, M. and Dr. Wegner, I. |
| Faculty: | Medical Sciences |
| Date Deposited: | 19 Aug 2024 11:03 |
| Last Modified: | 19 Aug 2024 11:03 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3743 |
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