Head & neck · 2025
Minimizing Chemoradiation Using a Surgical Algorithm for HPV-Associated Cancer of Unknown Primary.
СтатьяНазвание и аннотация: Перевод в очереди
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Daoud Georges E, Burnham Andre J, Vettikattu Nikhil T, Schmitt Nicole C, Boyce Brian J, Gross Jennifer H, Baddour Harry M, El-Deiry Mark W, Steuer Conor E, Saba Nabil F, Bates James E, Stokes William A, Magliocca Kelly R, Patel Mihir R, Kaka Azeem S
Аннотация
BACKGROUND: The majority of lesions originally diagnosed as cancer of unknown primary (CUP) are eventually identified as HPV-associated oropharyngeal squamous cell carcinoma. Accurate primary tumor localization can facilitate targeted treatment or reduce adjuvant therapy.
METHODS: This retrospective study examined patients who underwent transoral robotic surgery (TORS) for CUP from 2019 to 2022 at a tertiary care center. We analyzed the primary tumor identification rate, recurrence rate, and need for adjuvant therapy.
RESULTS: A total of 48 patients with HPV-associated CUP underwent TORS, achieving an 87.5% identification rate (42/48). A total of 39.5% (19/48) avoided direct radiation to the primary site, and 20.8% (10/48) received no radiation. No patients had local recurrence, though three experienced regional or distant recurrence.
CONCLUSIONS: A primary surgical approach to HPV-associated CUP of the head and neck should be considered in every patient with CUP. When combined with a robust frozen section pathology protocol helping to guide intraoperative decision-making and margin revision, and a multidisciplinary approach to adjuvant therapy, precise tumor localization can help appropriately direct adjuvant therapy.
METHODS: This retrospective study examined patients who underwent transoral robotic surgery (TORS) for CUP from 2019 to 2022 at a tertiary care center. We analyzed the primary tumor identification rate, recurrence rate, and need for adjuvant therapy.
RESULTS: A total of 48 patients with HPV-associated CUP underwent TORS, achieving an 87.5% identification rate (42/48). A total of 39.5% (19/48) avoided direct radiation to the primary site, and 20.8% (10/48) received no radiation. No patients had local recurrence, though three experienced regional or distant recurrence.
CONCLUSIONS: A primary surgical approach to HPV-associated CUP of the head and neck should be considered in every patient with CUP. When combined with a robust frozen section pathology protocol helping to guide intraoperative decision-making and margin revision, and a multidisciplinary approach to adjuvant therapy, precise tumor localization can help appropriately direct adjuvant therapy.