Background:The proportion of oropharyngeal cancers, especially those that are HPV-associated, is increasing, and both surgery and RT are considered effective initial treatments for early-stage oropharyngeal cancer, regardless of p16 status. However, there are still many unknowns regarding the long-term prognosis after initial treatment, the incidence rate of multiple cancers, and the relationship with p16 status.Methods: We retrospectively analyzed 94 cases of T1/2N0 oropharyngeal squamous cell carcinomas (OPSCCs) treated with surgery or radiotherapy between January 2000 and December 2012 at the Japan National Cancer Center Hospital East. The study items include long-term prognosis, p16 status, and the proportion of patients with multiple cancers after receiving treatment for oropharyngeal cancer.Results: The patients included 80 men and 14 women, whose median age was 68 (35–92). The median follow-up time was 2131 days. T1N0 cancer was observed in 34 patients and T2N0 in 60 patients. Surgery was performed for 74 patients, and radiotherapy for 20 patients. Of the patients who underwent surgery, 57 underwent transoral surgery, and 17 underwent pharyngectomy via transcervical approach. Nine of the 17 patients underwent partial pharyngectomy with free-flap reconstruction. The 5-year overall survival rates were 74.9 and 51.0% (p= 0.035); the 5-year disease-specific survival rates were 86.0 and 64.5% (p= 0.116); and the 5-year local control rates, 76.5 and 59.1% (p= 0.106) for the surgery and radiotherapy groups, respectively. Furthermore, 54 (57.4%) of the 94 cases suffered from multiple primary cancers, of which 29 (30.9%) were in the head and neck region and all were metachronous.Conclusions: Initial surgery for T1/2N0 OPSCCs is a proper therapeutic strategy considering the better overall survival and high incidence of multiple primary cancers.
背景：口咽癌（特别是HPV相关型）的发病率呈上升趋势，无论p16状态如何，手术与放疗均被视为早期口咽癌的有效初始治疗方案。然而，关于初始治疗后的长期预后、多原发癌发生率及其与p16状态的关系仍存在诸多未知。 方法：本研究回顾性分析了2000年1月至2012年12月期间在日本国立癌症研究中心东院接受手术或放疗治疗的94例T1/2N0期口咽鳞状细胞癌患者。研究内容包括长期预后、p16状态以及口咽癌治疗后发生多原发癌的比例。 结果：94例患者中男性80例、女性14例，中位年龄68岁（范围35-92岁）。中位随访时间为2131天。T1N0期34例，T2N0期60例。74例接受手术治疗，20例接受放疗。手术患者中57例接受经口手术，17例经颈径路行咽切除术，其中9例同时进行游离皮瓣修复术。手术组与放疗组的5年总生存率分别为74.9%和51.0%（p=0.035），5年疾病特异性生存率分别为86.0%和64.5%（p=0.116），5年局部控制率分别为76.5%和59.1%（p=0.106）。此外，94例中有54例（57.4%）发生多原发癌，其中头颈部区域29例（30.9%），均为异时性癌。 结论：鉴于手术组患者总生存率更优且多原发癌发生率较高，对T1/2N0期口咽鳞癌采取初始手术治疗是合理的治疗策略。
肿瘤(癌症)患者之家