Complete pathologic response as a prognostic factor for squamous cell carcinoma of the oropharynx post-chemoradiotherapy

Braz J Otorhinolaryngol. 2015 Sep-Oct;81(5):498-504. doi: 10.1016/j.bjorl.2015.07.009. Epub 2015 Jul 21.

Abstract

Introduction: Chemoradiotherapy for squamous cell carcinoma of the oropharynx (SCCO) provides good results for locoregional disease control, with high rates of complete clinical and pathologic responses, mainly in the neck.

Objective: To determine whether complete pathologic response after chemoradiotherapy is related to the prognosis of patients with SCCO.

Methods: Data were prospectively extracted from clinical records of N2 and N3 SCCO patients submitted to a planned neck dissection after chemoradiotherapy.

Results: A total of 19 patients were evaluated. Half of patients obtained complete pathologic response in the neck. Distant or locoregional recurrence occurred in approximately 42% of patients, and 26% died. Statistical analysis showed an association between complete pathologic response and lower disease recurrence rate (77.8% vs. 20.8%; p=0.017) and greater overall survival (88.9% vs. 23.3%; p=0.049).

Conclusion: The presence of a complete pathologic response after chemoradiotherapy positively influences the prognosis of patients with SCCO.

Introdução: O tratamento baseado em quimirradioterapia do Carcinoma Espinocelular de Orofaringe (CECOF) apresenta bons resultados no controle locorregional da doença com boas taxas de resposta clínica e patológica completas especialmente no pescoço.

Objetivo: Determinar se a resposta patológica completa após quimiorradioterapia estárelacionada aos prognósticos dos pacientes com CECOF.

Método: Os dados foram obtidos de maneira prospectiva da revisão de prontuários de pacientes com CECOF N2 e N3 submetidos a esvaziamento cervical planejado após quimiorradioterapia.

Resultados: Um total de 19 pacientes foram avaliados. Metade dos indivíduos apresentou resposta patológica completa no pescoço. Recidiva à distância ou locorregional ocorreu em aproximadamente 42% dos pacientes e 26% deles morreram. A análise estatística demonstrou uma associação entre resposta patológica completa e menor taxa de recidiva (77,8% vs. 20,8%; p = 0,017) e maior sobrevivência global (88,9% vs. 23,3%; p = 0,049).

Conclusão: A presença de resposta patológica completa após quimiorradioterapia influencia positivamente no prognóstico de pacientes com carcinoma espinocelular de orofaringe.

Keywords: Carcinoma; Carcinoma de células escamosas; Combined chemotherapy; Esvaziamento cervical; Neck dissection; Orofaringe; Oropharynx; Quimioterapia combinada; Squamous cell.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / administration & dosage*
  • Carcinoma, Squamous Cell / drug therapy*
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / surgery
  • Combined Modality Therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neck Dissection
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Oropharyngeal Neoplasms / drug therapy*
  • Oropharyngeal Neoplasms / mortality
  • Oropharyngeal Neoplasms / surgery
  • Prognosis
  • Survival Rate
  • Treatment Outcome

Substances

  • Antineoplastic Agents