Efficacy, outcomes, and complication rates of different surgical and nonsurgical treatment modalities for recurrent/residual oropharyngeal carcinoma: A systematic review and meta-analysis

Head Neck. 2016 Dec;38(12):1855-1861. doi: 10.1002/hed.24531. Epub 2016 Jul 13.

Abstract

Background: Treatment of recurrent oropharyngeal cancer is widely thought to have poor outcomes. Justification for treatment, especially in advanced cases, can be difficult.

Methods: A systematic search of MEDLINE, Embase, and Cochrane databases was conducted. Included studies reported specific recurrent oropharyngeal cancer survival data.

Results: Twenty-two retrospective studies were included. Pooled 3-year overall survival (OS) was 26% (95% confidence interval [CI] = 22% to 29%; I squared = 40.7%; p = .057). Pooled 5-year OS was 23% (95% CI = 20% to 27%; I squared = 73.9%; p = .000). Surgical treatment was superior to radiation (5-year OS 26% vs 16%, respectively; p < .001). The 5-year OS improved over time: 18% in the pre-2000 cohort; 35% in the mixed pre-2000 and post-2000 group; and 51% in the post-2000 cohort (p < .001).

Conclusion: Outcomes have improved considerably over the last 2 decades, resulting in approximately 50% overall 5-year survival. Human papillomavirus (HPV) status, patient selection, and improvements in care may explain this. © 2016 The Authors Head & Neck Published by Wiley Periodicals, Inc. Head Neck, 2016 © 2016 Wiley Periodicals, Inc. Head Neck 38: 1855-1861, 2016.

Keywords: cancer; malignancy; oropharynx; radiotherapy; surgery.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Chemoradiotherapy / methods
  • Female
  • Humans
  • Male
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / therapy*
  • Neoplasm, Residual / mortality
  • Neoplasm, Residual / pathology
  • Neoplasm, Residual / therapy*
  • Oropharyngeal Neoplasms / mortality
  • Oropharyngeal Neoplasms / pathology*
  • Oropharyngeal Neoplasms / therapy*
  • Pharyngectomy / methods
  • Prognosis
  • Risk Assessment
  • Survival Analysis
  • Treatment Outcome