Risk of recurrence after neoadjuvant chemotherapy and transoral robotic surgery in patients with oropharynx cancer that avoid adjuvant radiation.
Alisha R PershadPunam G ThakkarJoseph F GoodmanArjun JoshiSeth M SteinbergClint T AllenCharalampos S FloudasPublished in: Cancer medicine (2024)
Comparing outcomes in 103 patients between 2008 and 2023, 92% avoided adjuvant treatment and showed significantly higher 2-year recurrence-free survival (RFS) compared to those with adjuvant treatment (95.9% vs. 43.8%, p = 0.0049) CONCLUSION: Our findings suggest that pathology-based risk-adapted omission of adjuvant treatment following NAC + S does not appear to elevate recurrence risk and that NAC may identify patients with favorable tumor biology, yielding a 2-year RFS probability exceeding 95% without adjuvant treatment. Further, the study identifies a patient subset experiencing disease recurrence despite triple modality therapy. Despite limitations, including a retrospective design and modest sample size, the data advocate for controlled NAC + S studies.
Keyphrases
- free survival
- neoadjuvant chemotherapy
- early stage
- transcription factor
- stem cells
- lymph node
- end stage renal disease
- chronic kidney disease
- type diabetes
- gene expression
- ejection fraction
- newly diagnosed
- bone marrow
- insulin resistance
- electronic health record
- metabolic syndrome
- replacement therapy
- cell therapy
- peritoneal dialysis
- lymph node metastasis