Correspondence Patrick Sheahan, Department of Otolaryngology – Head and Neck Surgery, South Infirmary Victoria University Hospital, Cork, Ireland. Email: [email protected]Search for more papers by this author

Peter Molony MB, MRCPI,

Peter Molony MB, MRCPI

Department of Pathology, Cork University Hospital, Cork, Ireland

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Natallia Kharytaniuk MB,

Natallia Kharytaniuk MB

Department of Otolaryngology – Head and Neck Surgery, South Infirmary Victoria University Hospital, Cork, Ireland

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Seamus Boyle MB,

Seamus Boyle MB

Department of Otolaryngology – Head and Neck Surgery, South Infirmary Victoria University Hospital, Cork, Ireland

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Robbie S. R. Woods MB, MRCSI,

Robbie S. R. Woods MB, MRCSI

Department of Otolaryngology – Head and Neck Surgery, South Infirmary Victoria University Hospital, Cork, Ireland

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Gerard O'Leary MB, FRCSI,

Gerard O'Leary MB, FRCSI

Department of Otolaryngology – Head and Neck Surgery, South Infirmary Victoria University Hospital, Cork, Ireland

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Reiltin Werner MSc,

Reiltin Werner MSc

Department of Pathology, Cork University Hospital, Cork, Ireland

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Cynthia Heffron MB, MRCPath,

Cynthia Heffron MB, MRCPath

Department of Pathology, Cork University Hospital, Cork, Ireland

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Linda Feeley MB, MRCPath,

Linda Feeley MB, MRCPath

Department of Pathology, Cork University Hospital, Cork, Ireland

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Patrick Sheahan MB, FRCSI (ORL-HNS),

Corresponding Author

Patrick Sheahan MB, FRCSI (ORL-HNS)

[email protected]

orcid.org/0000-0002-9153-8951

Department of Otolaryngology – Head and Neck Surgery, South Infirmary Victoria University Hospital, Cork, Ireland

First published: 31 May 2017

https://doi.org/10.1002/hed.24824

Citations: 40

Funding information: Funding for the p16 staining was provided by the Head and Neck Oncology Fund, South Infirmary Victoria University Hospital.

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Abstract

Background

Currently, positive surgical margins in head and neck cancer are considered to be an indicator for postoperative chemoradiotherapy (CRT) over radiotherapy (RT) alone. However, there are less data regarding the impact of margin status on human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (SCC).

Methods

We performed a retrospective review of 55 patients with oropharyngeal SCC undergoing primary surgical treatment. The impact of margin status on disease-specific survival (DSS) was studied according to p16 status.

Results

Twenty-one patients had positive margins. Adjuvant treatment in these cases was CRT (n = 6), RT alone (n = 14), and none (n = 1). Among p16-negative patients, positive margins and dysplasia at margins predicted significantly worse DSS. Among patients with p16-positive disease, margin status had no impact on DSS.

Conclusion

Patients with p16-positive oropharyngeal SCC and positive margins after excision maintain a low risk of recurrence despite most receiving RT alone as adjuvant treatment. These findings raise questions regarding the additional benefit of postoperative CRT in this group.

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Volume39, Issue8

August 2017

Pages 1680-1688

Impact of positive margins on outcomes of oropharyngeal squamous cell carcinoma according to p16 status

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Impact of positive margins on outcomes of oropharyngeal squamous cell carcinoma according to p16 status

Abstract

Background

Methods

Results

Conclusion

REFERENCES

Citing Literature

References

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