Does elimination of planned postoperative radiation to the primary bed in p16-positive, transorally-resected oropharyngeal carcinoma associate with poorer outcomes?

Transoral surgery (TOS) for head and neck primaries allows carefully-controlled intraoperative margin analysis, resulting in high margin-negative resection and low local recurrence rates [1–4]. Reported outcomes from observational studies in the literature on oropharynx squamous cell carcinoma (OPSCC) indicate that avoidance of radiation to the primary site may result in good local control although no data specific to human papillomavirus (HPV) or p16-positivity is presented [1,5]. For instance, a 5-year Kaplan-Meier local control of 94% was observed in a series of 69 patients with tongue base tumors (T1-T3) treated with transoral laser microsurgery (TLM) alone, but without HPV/p16 stratification [5].

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