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Impact of surgical margins on local control in patients undergoing single‐modality transoral robotic surgery for HPV‐related oropharyngeal squamous cell carcinoma
Author(s) -
Holcomb Andrew J.,
Herberg Matthew,
Strohl Madeleine,
Ochoa Edgar,
Feng Allen L.,
Abt Nicholas B.,
Mokhtari Tara E.,
Suresh Krish,
McHugh Christopher I.,
Parikh Anuraag S.,
Sadow Peter,
Faquin William,
Faden Daniel,
Deschler Daniel G.,
Varvares Mark A.,
Lin Derrick T.,
Fakhry Carole,
Ryan William R.,
Richmon Jeremy D.
Publication year - 2021
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.26708
Subject(s) - medicine , transoral robotic surgery , surgery , basal cell , adjuvant , retrospective cohort study , surgical margin , resection
Background The impact of close surgical margins on oncologic outcomes in HPV‐related oropharyngeal squamous cell carcinoma (HPV + OPSCC) is unclear. Methods Retrospective case series including patients undergoing single modality transoral robotic surgery (TORS) for HPV + OPSCC at three academic medical centers from 2010 to 2019. Outcomes were compared between patients with close surgical margins (<1 mm or requiring re‐resection) and clear margins using the Kaplan–Meier method. Results Ninety‐nine patients were included (median follow‐up 21 months, range 6–121). Final margins were close in 22 (22.2%) patients, clear in 75 (75.8%), and positive in two (2.0%). Eight patients (8.1%) recurred, including two local recurrences (2.0%). Four patients died during the study period (4.0%). Local control ( p = 0.470), disease‐free survival ( p = 0.513), and overall survival ( p = 0.064) did not differ between patients with close and clear margins. Conclusions Patients with close surgical margins after TORS for HPV + OPSCC without concurrent indications for adjuvant therapy may be considered for observation alone.