CC BY-NC-ND 4.0 · Laryngorhinootologie 2022; 101(S 02): S201
DOI: 10.1055/s-0042-1746634
Poster
Head-Neck-Oncology: Clinical studies

Relevance of the time interval between surgery and adjuvant radio(chemo)therapy in HPV-negative and advanced head and neck carcinoma of unknown primary (CUP)

Matthias Balk
1   Friedrich-Alexander University Erlangen-Nürnberg (FAU), Department of Otolaryngology, Head & Neck Surgery, University Hospital Erlangen, Waldstraße 1, 91054 Erlangen, Germany. Erlangen
,
Robin Rupp
1   Friedrich-Alexander University Erlangen-Nürnberg (FAU), Department of Otolaryngology, Head & Neck Surgery, University Hospital Erlangen, Waldstraße 1, 91054 Erlangen, Germany. Erlangen
,
Konstantin Mantsopoulos
1   Friedrich-Alexander University Erlangen-Nürnberg (FAU), Department of Otolaryngology, Head & Neck Surgery, University Hospital Erlangen, Waldstraße 1, 91054 Erlangen, Germany. Erlangen
,
Moritz Allner
1   Friedrich-Alexander University Erlangen-Nürnberg (FAU), Department of Otolaryngology, Head & Neck Surgery, University Hospital Erlangen, Waldstraße 1, 91054 Erlangen, Germany. Erlangen
,
Philipp Grundtner
1   Friedrich-Alexander University Erlangen-Nürnberg (FAU), Department of Otolaryngology, Head & Neck Surgery, University Hospital Erlangen, Waldstraße 1, 91054 Erlangen, Germany. Erlangen
,
Sarina Müller
1   Friedrich-Alexander University Erlangen-Nürnberg (FAU), Department of Otolaryngology, Head & Neck Surgery, University Hospital Erlangen, Waldstraße 1, 91054 Erlangen, Germany. Erlangen
,
Maximilian Traxdorf
2   Klinik für Hals-, Nasen-, Ohren-Erkrankungen (HNO) und Kopf-, Hals-Chirurgie, Klinikum Nürnberg Nord Nürnberg
,
Markus Eckstein
3   Friedrich-Alexander University Erlangen-Nürnberg (FAU), Department of Pathology, University Hospital Erlangen, Krankenhausstraße 8-10, 91054 Erlangen, Germany. Erlangen
,
Stefan Speer
4   Friedrich-Alexander University Erlangen-Nürnberg (FAU), Department of Radiation Oncology, University Hospital Erlangen, Universitätsstraße 27, 91054 Erlangen, Germany. Erlangen
,
Sabine Semrau
4   Friedrich-Alexander University Erlangen-Nürnberg (FAU), Department of Radiation Oncology, University Hospital Erlangen, Universitätsstraße 27, 91054 Erlangen, Germany. Erlangen
,
Rainer Fietkau
4   Friedrich-Alexander University Erlangen-Nürnberg (FAU), Department of Radiation Oncology, University Hospital Erlangen, Universitätsstraße 27, 91054 Erlangen, Germany. Erlangen
,
Heinrich Iro
1   Friedrich-Alexander University Erlangen-Nürnberg (FAU), Department of Otolaryngology, Head & Neck Surgery, University Hospital Erlangen, Waldstraße 1, 91054 Erlangen, Germany. Erlangen
,
Markus Hecht
4   Friedrich-Alexander University Erlangen-Nürnberg (FAU), Department of Radiation Oncology, University Hospital Erlangen, Universitätsstraße 27, 91054 Erlangen, Germany. Erlangen
,
Antoniu-Oreste Gostian
1   Friedrich-Alexander University Erlangen-Nürnberg (FAU), Department of Otolaryngology, Head & Neck Surgery, University Hospital Erlangen, Waldstraße 1, 91054 Erlangen, Germany. Erlangen
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    This study aimed to assess the impact of the time interval between surgery and adjuvant therapy (AT) on the oncologic outcome, in particular the 5-year overall survival rate (OS), in advanced stage, HPV-negative CUPs at a tertiary referral hospital. 5-year disease specific survival rate (DSS) and progression free survival rate (PFS) are defined as secondary objectives.

    Between January 1st, 2007, and March 31st, 2020, 59 patients with a negative p16 analysis were referred to a CUP-panendoscopy with simultaneous unilateral neck dissection followed by AT. The cut-off between tumor removal and delivery of AT was set at the median, i.e. patients receiving AT below or above the median time interval. Depending on the median time interval of 55 days (d) (95% CI 51.42-84.52), 30 patients received AT within 55 d (mean 41.69 d, SD=9.03) after surgery in contrast to 29 patients at least after 55 d (mean 73.21 d, SD=19.16).

    The OS was 81.4% (95% CI 0.55-0.86). For those patients receiving AT in < 55 d (83.3%, 95% CI 0.48-1.06) it was not significantly different from those with delayed treatment (75.9%, 95% CI 0.42-0.80; X2 (1) =1.16, p=0.281).The DSS was 89.8% (95% CI 0.75-0.96). Patients submitted to AT in < 55 d the DSS was 96.7% (95% CI 0.89-1.01) compared to patients submitted to AT in >/- 55 d (82.8% (95% CI 0.57-0.95; X2 (1) =2.32, p=0.128). The PFS was 76.3% (95% CI 0.59-0.85). In the group < 55 d the PFS was 80% (95% CI 0.63-0.94) and thus not significantly different from 72.4% (95% CI 0.45-0.85) of the group >/- 55 d; (X2 (1) =0.29, p=0.589). The oncologic outcome of patients with advanced, HPV-negative CUP of the head and neck was not significantly affected by a prolonged period between surgery and AT. Nevertheless, oncologic outcome tends to be superior for early AT.


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    Conflict of Interest

    The author declares that there is no conflict of interest.

    Publication History

    Article published online:
    24 May 2022

    © 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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