Saved in:
| Main Authors: | , |
|---|---|
| Format: | Artículo Open Access |
| Published: |
Wiley
2026
|
| Subjects: | |
| Online Access: | https://aao-hnsfjournals.onlinelibrary.wiley.com/doi/10.1002/ohn.70100 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
Table of Contents:
- A National Analysis of Microscopic Positive Margins in Oropharyngeal Cancer Patients Undergoing Transoral Robotic Surgery Aaron Tucker Craig A. Bollig Otolaryngology–Head and Neck Surgery Abstract Objective The objective was to identify clinical variables associated with microscopic positive margins (PMs) during transoral robotic surgery (TORS) for oropharyngeal cancer (OPC) resection, and to explore the association of the receipt of adjuvant treatment with overall survival (OS) in this population. Study Design Retrospective cohort analysis. Setting 2019 Patient User File of the National Cancer Database. Methods Patients >18 years of age with OPC were stratified based on margin status. Multivariable logistic regression was used to identify clinical variables associated with PM. Survival analyses were performed using multivariable Cox proportional hazards models. Adjusted odds ratios (aORs) and hazard ratios (aHRs) with associated 95% confidence intervals (CIs) were generated. Results In total, 4294 patients met the criteria. The PM rate was 16.6%. Human papillomavirus (HPV)‐negative squamous cell carcinoma (SCCa), salivary gland carcinoma, clinical T category, base of tongue primary site, and treatment at low‐volume, nonacademic institutions were independently associated with PM. PMs were associated with increased mortality (aHR 1.67, 95% CI: 1.40‐1.99). In patients with PM, but without extranodal extension (ENE), adjuvant radiation therapy (aRT) (aHR 0.29, 95% CI: 0.19‐0.45) and adjuvant chemoradiotherapy (aCRT) (aHR 0.31, 95% CI: 0.21‐0.45) were associated with an improvement in OS versus surgery alone; however, OS between aRT and aCRT was similar for both HPV‐positive and HPV‐negative SCCa. Conclusion Histologic type, clinical T category, tumor subsite, and treatment at low‐volume, nonacademic institutions were independently associated with TORS PM. aCRT did not confer a survival benefit over aRT in the overall cohort, or in subgroups of HPV‐associated or HPV‐negative SCCa patients with PM without ENE. 10.1002/ohn.70100 http://creativecommons.org/licenses/by/4.0/