Investigation of p16-positive oropharyngeal squamous cell carcinomas in the lateral wall treated with TPF induction chemotherapy followed by transoral resection combined with neck dissection: Safety and treatment outcomes

Abstract

We investigated 16 patients with p16-positive oropharyngeal squamous cell carcinomas in the lateral wall who received induction chemotherapy with docetaxel, cisplatin, and fluorouracil （TPF-ICT）, followed by simultaneous transoral resection combined with neck dissection. The following post-operative complications were observed in one patient each: bleeding, chylothorax, pneumonia, and velopharyngeal insufficiency. The 3-year loco-regional control, overall survival, and disease-free survival rates were 100％, 100％, and 92.9％, respectively. Post-operative pathological examinations revealed a positive surgical margin and extranodal extension in two patients and one patient, respectively. Of these three patients, two received chemoradiation and one radiation therapy. The remaining patients needed no post-operative （chemo） radiation therapy. These findings indicate that TPF-ICT, followed by transoral resection combined with neck dissection, can be performed safely. However, it is important to archive negative surgical margin tissue from the primary site and predict the pre-existing extranodal extension before treatment to avoid post-operative （chemo） radiation therapy.