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ArticleStrahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]2019

Definitive radiochemotherapy or initial surgery for oropharyngeal cancer : To what extent can p16 expression be used in the decision process?

Anouchka Modesto, Thibaut Galissier, Amélie Lusque, Jean-Pierre Delord, Emmanuelle Uro-Coste, Jérôme Sarini, Frédéric Mouchet, Raphaël Lopez, Anne Laprie, Pierre Graff and 2 more

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Trial
  2. Upfront surgery versus definitive radiotherapy: competing risk analyses for cancer-specific and noncancer mortality in oropharyngeal cancer.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2024
    Article
  3. Article
  4. Article
  5. Single-cycle induction chemotherapy before chemoradiotherapy or surgery in functionally inoperable head and neck squamous cell carcinoma: 10-year results.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2020
    Article
  6. Radiogenomics in head and neck cancer: correlation of radiomic heterogeneity and somatic mutations in TP53, FAT1 and KMT2D.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2019
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Anouchka ModestoRadiation Oncology Department, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, 1 avenue Irène Joliot-Curie, Cedex 9, 31059, Toulouse, France. modesto.anouchka@iuct-oncopole.fr.ORCID http://orcid.org/0000-0003-2133-6454
Thibaut GalissierPathology Department, Centre Hospitalo-Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse, 1 avenue Irène Joliot-Curie, Cedex 9, 31059, Toulouse, France.
Amélie LusqueBiostatistics Department, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, 1 avenue Irène Joliot-Curie, Cedex 9, 31059, Toulouse, France.
Jean-Pierre DelordMedical Oncology Department, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, 1 avenue Irène Joliot-Curie, Cedex 9, 31059, Toulouse, France.
Emmanuelle Uro-CostePathology Department, Centre Hospitalo-Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse, 1 avenue Irène Joliot-Curie, Cedex 9, 31059, Toulouse, France.
Jérôme SariniHead and Neck Surgery Department, Centre Hospitalo-Universitaire de Larrey, Institut Universitaire du Cancer de Toulouse, 1 avenue Irène Joliot-Curie, Cedex 9, 31059, Toulouse, France.
Frédéric MouchetHead and Neck Surgery Department, Clinique Ambroise Paré, Toulouse, France.
Raphaël LopezMaxillo-facial Surgery Department, CHU Toulouse Purpan, 1 place Baylac, Toulouse, France.
Anne LaprieRadiation Oncology Department, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, 1 avenue Irène Joliot-Curie, Cedex 9, 31059, Toulouse, France.
Pierre GraffRadiation Oncology Department, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, 1 avenue Irène Joliot-Curie, Cedex 9, 31059, Toulouse, France.
Sébastien VergezHead and Neck Surgery Department, Centre Hospitalo-Universitaire de Larrey, Institut Universitaire du Cancer de Toulouse, 1 avenue Irène Joliot-Curie, Cedex 9, 31059, Toulouse, France.
Michel RivesRadiation Oncology Department, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, 1 avenue Irène Joliot-Curie, Cedex 9, 31059, Toulouse, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe decision between definitive radio(chemo)therapy (RCT) or a surgical strategy, i. e. surgery ± adjuvant radio(chemo)therapy for optimal treatment of oropharyngeal cancer is highly debated. Human papillomavirus(HPV)-related tumours are a distinct entity associated with p16 overexpression. While this represents a major prognostic factor, its predictive significance remains unknown.

resultsAmong 183 consecutive unselected patients treated between 2009 and 2013 with a state-of-the-art surgical procedure ± adjuvant radio(chemo)therapy or definitive RCT including intensity-modulated radiotherapy, 3‑year disease-free survival (DFS) was 74 vs. 57%, respectively (p = 0.007). When focusing on p16+ patients (49%), there was no significant difference in tumour control rate between surgery ± radio(chemo)therapy and the definitive RCT group (3-year DFS 83 vs. 82%, respectively; p = 0.48). However, delayed severe dysphagia was significantly lower in favour of definitive RCT: 35 vs. 4%, respectively; p = 0.0002.

conclusionOur results highlight distinct outcomes after definitive RCT or initial surgical treatment according to p16 status, which should thus be considered during the decision process.

Indexed as

ChemoradiotherapyDecision Support TechniquesAdultAgedAged, 80 and overCombined Modality TherapyCyclin-Dependent Kinase Inhibitor p16Disease-Free SurvivalFemaleGene ExpressionHumansMaleMiddle AgedOropharyngeal NeoplasmsCDKN2A protein, humanCyclin-Dependent Kinase Inhibitor p16Genes, p16Human papillomavirusRadiotherapyRisk factorsSurvival

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.