Introduction:
In 2010, a paradigm shift was initiated in the treatment of HPV positive oropharyngeal carcinoma, in which primary surgery (OP) and possibly adjuvant radiotherapy/chemotherapy (STX) were superseded by the primary STX. We wondered if these changes in OPC + also led to changes in the treatment of HPV negative OPK (OPC-).
Methods:
Patients (Pat.) with OPC from 2007 to 2014 were evaluated for stage (Sta.), HPV status, tracheostomy and primary therapies surgery/RTX retrospectively. Two groups were formed: until May 2011 (G1) and from June 2011 (G2). In G1, there was generally no HPV status (OPCna) assessed; in G2, all patients were assessed for HPV status.
Results:
From a total of 87 patients, 33 G1 (25 OPCna, 3 OPC-, 5 OPC+) and 54 G2 (31 OPK-/23 OPK +) could be assigned. The stadium distributed as follows for G1/G2: Sta.1 – 3/6 Pat., Sta.2 – 3/6 pat., Stad.3 – 6/9 Pat., Stad.4 – 21/33 Pat.
In G1 49% (16/33) were tracheotomized, in G2 32% (17/54). In G1, 88% of all patients (n = 29) received surgery as primary intervention and 12% received RTX. In G2, 39% of all patients (n = 21) received surgery and 61% (n = 33) received RTX. G2 patients were tracheotomized and/or become surgery by 1/3 less. Compared with OPCna (G1 minus 8 pat.), in paients with OPK+ (G2) tracheostomy was only half as common and in OPK- (G2) patients 1/3 less. The probability for surgery for OPK + (G2) and OPK- (G2) was 1/3 less.
Conclusion:
For the investigated patient collective, it has been shown that irrespective of HPV status since June 2011, primary surgery and tracheostomy is less frequent. Maybe, the more frequent indication for irradiation in OPK + also affects the therapy decision in OPK-.
