Oncologic outcomes of surgically treated early-stage oropharyngeal squamous cell carcinoma

Background: The purpose of this study was to characterize oncologic outcomes in early (T1–T2, N0) and intermediate (T1–T2, N1) oropharyngeal squamous cell carcinoma (SCC) after surgery. Methods: Patients with oropharyngeal SCC treated with surgery were identified from 2 academic institutions. Results: Of 188 patients, 143 met the inclusion criteria. Eighty-six (60%) had T1 to T2 N0 and 57 (40%) had T1 to T2 N1 disease. Sixty-five patients (45%) underwent a robotic-assisted resection, whereas the remaining had transoral (n = 60; 42%), mandible-splitting (n = 11; 8%), or transhyoid approaches (n = 7; 5%). Human papillomavirus (HPV) status was known for 97 patients (68%), and 54 (55%) were HPV positive. Three-year recurrence-free survival (RFS) was 82% (95% confidence interval [CI] = 0.75–0.89). Since 2008, HPV infection was protective of recurrence (log-rank p =.0334). A single node did not increase the risk of recurrence (p =.467) or chance of a second primary (p =.175). Conclusion: Complete surgical resection is effective therapy for early and intermediate oropharyngeal SCC. HPV-negative patients were at increased risk for locoregional recurrence or second primary disease.