In patients older than 70 years, the treatment of human papillomavirus-associated oropharyngeal cancers has remained controversial. It is partly because the inclusion of older adults in clinical trials has been limited. This study aims to evaluate the oncologic outcome of recently introduced transoral robotic surgery for human papillomavirus-associated oropharyngeal cancer in older adults.
This retrospective cohort study included a total of 77 patients aged 70 years or older with biopsy-proven and surgically resectable p16-positive oropharyngeal cancers. All the patients underwent transoral robotic surgery oropharyngeal resection and neck dissection with adjuvant therapy. The primary outcome of this study was three-year estimates of disease-specific survival, overall survival, and disease-free survival.
The rate of perioperative mortality was 1.3%, and the rate of oropharyngeal hemorrhage was 2.6%. A total of 27 patients (35.1%) underwent postoperative radiotherapy, whereas 20 patients (26%) underwent postoperative chemotherapy. The median follow-up length was 39.6 months. The three-year estimates were found to be 92.4% for disease-specific survival, 90% for overall survival, and 84.3% for disease-free survival.
The research concluded that transoral robotic surgery and pathologic characteristic–guided adjuvant therapy was associated with positive outcomes in older adults with papillomavirus-associated oropharyngeal cancer. The positive outcomes included better survival outcomes and infrequent perioperative mortality.