To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: Greater Accuracy in Staging Can Influence Long-Term Treatment Options in Oropharyngeal Cancer: Presented at AHNS URL: http://www.pslgroup.com/dg/226416.htm Doctor's Guide July 23, 2008
By Arushi Sinha SAN FRANCISCO -- July 23, 2008 -- Primary surgical treatment does not appear to provide benefits to patients with stage I or II oropharyngeal squamous cell carcinoma, whereas in patients with occult metastases, these procedures offer the opportunity for upstaging and intensification of therapy, according to research presented here at the American Head and Neck Society 7th International Conference on Head and Neck Cancer (AHNS). Disease staging helps to determine treatment plans and prognosis in patients with oropharyngeal squamous cell carcinoma, so accuracy in staging has definite clinical implications, the researchers noted during their presentation on July 22. To assess the accuracy of staging information, they reviewed the records of 49 patients with oropharyngeal squamous cell carcinomas, including primary carcinomas of the tonsil (53%), base of tongue (33%), or posterior pharyngeal wall (14%). "When we went back to our results on surgical staging and actually looked at the pathology, some of the tumours were upstaged and some were downstaged," explained Rohan Walvekar, MD, Department of Otolaryngology -- Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana. Dr. Walvekar conducted the study while he was at the University of Pittsburgh. Clinical staging data showed that 61% of patients were either stage I or II, and 39% were stage III. With reference to nodal involvement, 58% were N0 and 42% were N1. As part of the initial workup, neck dissections were performed in 46 of the 49 patients. When compared with clinical staging, neck dissection altered nodal status in 23% of patients and T stage changed in 26% of patients. Combined, neck dissection changed the diagnosis in 40% of patients. Thirty-five patients received a median follow-up of 8 years, during which 28% of stage I patients and 15% of stage II patients received radiation therapy but no chemotherapy. Among stage III patients, 33% underwent surgery, 47% received additional radiation, and 20% received chemoradiotherapy. Based on additional findings for staging, chemotherapy was eliminated for 80% of stage III patients. These factors did not influence disease-free survival in 85% or overall survival in 83%. Based on these results, the authors concluded that a clearer picture at the time of staging can influence the treatment plan, particularly for patients with stage I or II disease. "With better visualisation, we are able to remove these tumours more effectively," said Dr. Walvekar. "Younger patients are coming to us, and since we know that these cancers have a 15% to 20% recurrence rate, it becomes important to leave the radiotherapy options available." [Presentation title: Role of Surgery in Limited (T1-2, N0-1) Cancers of the Oropharyngeal. Abstract P637] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.