Comparison of In-Office and General Anesthesia Biopsies for Oropharyngeal Squamous Cell Carcinoma in a Public Healthcare System.

BACKGROUND

We compared treatment delays, costs, and management impact between oropharyngeal squamous cell carcinoma (OPSCC) patients undergoing in-office versus general anesthesia panendoscopy-guided biopsies in two large tertiary centers in a public healthcare system.

METHODS

All OPSCC patients included were treated between 2010 and 2024 with either curative radiation alone or chemoradiation.

RESULTS

Demographic and tumor characteristics were comparable, except for smaller tumors in the panendoscopy group (n = 36) compared to the in-office group (n = 37) (mean size; 29.4 mm vs. 36.6 mm, respectively; difference -7.2 mm [95% CI, -11.3 to -3.1]). The panendoscopy group experienced substantially longer treatment initiation delays (mean days; 70.1 days vs. 44.5 days; difference 25.7 days [95% CI 13.0 to 38.2]). No additional synchronous tumors were detected through panendoscopy. Panendoscopy incurred a mean additional cost of 2025CAD $3886.

CONCLUSIONS

Panendoscopy for OPSCC prolongs treatment initiation, incurs additional expenses, and provides no incremental synchronous tumor detection. When clinically feasible, in-office biopsies should be preferred.