Does Surgery Have a Relevant Role in the Primary Treatment of Locoregionally Advanced Oropharyngeal Carcinomas?

Background: Treatment concepts for oropharyngeal squamous cell carcinomas are controversial. This review compares the results obtained by distinct treatment options in locoregionally oropharyngeal advanced carcinomas: primary surgical resection followed by concurrent chemoradiotherapy and concurrent chemoradiotherapy alone. Methods: 57 patients with stage III and IV oropharyngeal squamous cell carcinoma were selected. 17 patients were treated with primary surgical resection followed by concurrent chemoradiotherapy and 40 patients were treated only with concurrent chemoradiotherapy. Statistical analysis was performed regarding survival rates according to tumor location, stage, treatment regimen and recurrence. Results: Two-year loco-regional control rates were 94% after surgery plus chemoradiotherapy and 55% after chemoradiotherapy (p = 0.016). Progression free survival rates were 88% and 27%, respectively (p < 0.001). Overall survival rates were 88% and 45%, respectively (p = 0.002). Conclusions: In this study, primary surgical resection followed by concurrent chemoradiotherapy showed better clinical outcomes with a lower risk of death associated with tumor and tumor progression.