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Updated: May 24, 2025
RNAscope for In situ Detection of Transcriptionally Active Human Papillomavirus in Head and Neck Squamous Cell Carcinoma
Published on: March 11, 2014
Margin Status and Recurrence in Surgically Treated Patients With HPV+ Oropharyngeal Cancer
Madeleine Ausburn1, Justin M Pyne1, Andrew T Day1
1Department of Otolaryngology, University of Texas at Southwestern Medical Center, Dallas, Texas, USA.
Background:
The optimal margins for surgically treated human papilloma virus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) remain undefined. We evaluated the impact of surgical margins on progression-free survival (PFS) in patients with HPV+ OPSCC treated with primary transoral robotic surgery (TORS).
Methods:
Patients undergoing primary TORS from May 2012 to December 2021 for intermediate-risk (T1-T2, resected to clear (≥ 3 mm) or close margins (< 3 mm), and N1-N2) HPV+ OPSCC were included. Survival outcomes were reviewed, and overall and PFS at 3 years posttreatment were determined using Kaplan-Meier analysis.
Results:
A total of 69 subjects met inclusion criteria. At a median follow-up of 47 months, overall survival (OS) was 100%, and the PFS was 88.9% for the entire subject group. Among subjects not receiving adjunctive radiotherapy (RT), those with close margins had an OS of 100% and a PFS of 100% (median follow-up 47 months). Subjects with clear margins had an OS probability of 100% and a PFS probability of 100% (median follow-up 47 months).
Conclusion:
In subjects undergoing TORS for HPV+ OPSCC, clear margins did not confer a significant OS or PFS survival advantage compared to those with close margins, even when adjuvant therapy was omitted.
