Abstract
The current study aimed to compare the therapeutic outcomes of surgery with those of concurrent chemoradiotherapy (CCRT) for patients with advanced oropharyngeal cancer (OPC), and to assess the role of salvage surgery for failure cases undergoing CCRT. In this study, we obtained the data for 523 patients with previously untreated OPC, and matched a group of patients who underwent surgery with a second group treated with CCRT according to age, gender, subsite, and T and N classification. The 5-year progression-free survival, and local control rates were 51.0% and 54.4% (p = 0.531), and 75.2% and 80.3% (p = 0.399), respectively, in patients treated with surgery and those treated with CCRT. Swallowing function in patients treated with CCRT was significantly better than that in patients treated with surgery (p = 0.015). On the other hand, of the 170 patients who received CCRT, 35 patients (21%) had local recurrence or residual disease and only 11 patients underwent further salvage surgery. In conclusion, this study showed that CCRT is as effective as surgery in the treatment of advanced OPC, however, the initial treatment method for OPC should be decided carefully in consideration of the limitations of salvage surgery.
