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Prognostic Factors of Limited T1-2N0-1 Oropharyngeal Cancers

Objective: Nonsurgical therapies, which utilize combinations of chemotherapy and radiotherapy, have become popular treatments for early oropharyngeal carcinomas (OPC). The aim of this study is to analyze the outcome of primary definitive surgical management of patients with limited OPC and assess the influence of various prognostic factors in survival. Method: A retrospective study was conducted between 1980 and 2007. A total of 266 surgically treated patients were included. The endpoints for the analysis were disease-specific survival (DSS) and local control (LC), with respect to T- and N-classification, status of margins, tumor depth, and type of treatment. Major complications were documented. Results: Overall 5-year DSS was 89.9% and LC 93.3%. The univariate analysis showed a significant difference in DSS between pT1 and pT2 OPC (DSS 94.0% vs 81.2%, P = .008) and patients with tumor depth greater than 5 mm (DSS 94.5% vs 78.9%, P = .031). No difference could be found according to N-stage, marginal status, HPV status, type of treatment, and adjuvant radiotherapy. Multivariate analysis showed that T-stage (HR = 2.49, 95% CI = 1.243-4.974, P = .01) and tumor depth (HR = 2.88, 95% CI = 1.055-7.865, P = .039) were independently associated with DSS. Incidence of major complications was 8% and mortality rate 0.7%. Conclusion: Primary surgical treatment is a very effective therapy against limited OPC independent to the surgical technique used. A low complication and mortality rate was documented. Patients with tumor depth of more than 5 mm have a significant worse survival and should be considered for adjuvant radiotherapy.