Abstract
Background
Some patients with human papillomavirus (HPV)–associated oropharyngeal squamous cell carcinoma (OPSCC) do not receive guideline‐recommended postoperative radiation therapy (PORT) following primary transoral robotic surgery (TORS).
Methods
Three‐hundred and sixty‐four patients with treatment‐naïve, HPV‐associated OPSCC were recommended to receive PORT based on clinicopathological features following TORS. Patients were stratified based on if they received PORT. Oncologic outcomes were compared.
Results
The 3‐year locoregional failure (LRF) was 32% in patients who did not receive PORT and 4% in patients who received PORT (P < .001). Despite increased LRF, avoiding PORT was not associated with increased 3‐year distant metastasis rates (8% vs 4%, P = .56) or worse 3‐year survival (95% vs 98%, P = .34). Recurrences in the surgery alone cohort varied between local and regional sites and were often successfully salvaged.
Conclusions
Patients with HPV‐associated OPSCC who do not receive indicated PORT have an increased risk of LRF but similar survival due to high salvage rates.
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