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Comparison of In-Office and General Anesthesia Biopsies for Oropharyngeal Squamous Cell Carcinoma in a Public
Samuel Bellavance1, Michel Khoury1, Justine Colivas2
1Division of Otolaryngology-Head and Neck Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montreal, Quebec, Canada.
Background:
We compared treatment delays, costs, and management impact between oropharyngeal squamous cell carcinoma (OPSCC) patients undergoing in-office versus general anesthesia panendoscopy-guided biopsies in two large tertiary centers in a public healthcare system.
Methods:
All OPSCC patients included were treated between 2010 and 2024 with either curative radiation alone or chemoradiation.
Results:
Demographic and tumor characteristics were comparable, except for smaller tumors in the panendoscopy group (n = 36) compared to the in-office group (n = 37) (mean size; 29.4 mm vs. 36.6 mm, respectively; difference -7.2 mm [95% CI, -11.3 to -3.1]). The panendoscopy group experienced substantially longer treatment initiation delays (mean days; 70.1 days vs. 44.5 days; difference 25.7 days [95% CI 13.0 to 38.2]). No additional synchronous tumors were detected through panendoscopy. Panendoscopy incurred a mean additional cost of 2025CAD $3886.
Conclusions:
Panendoscopy for OPSCC prolongs treatment initiation, incurs additional expenses, and provides no incremental synchronous tumor detection. When clinically feasible, in-office biopsies should be preferred.
