Evidence map›Paper›PMID 34771428›Full record

ArticleCancers2021

Upfront Surgery vs. Primary Chemoradiation in an Unselected, Bicentric Patient Cohort with Oropharyngeal Squamous Cell Carcinoma-A Matched-Pair Analysis.

Philipp H Zimmermann, Marijn Stuut, Nora Wuerdemann, Kathrin Möllenhoff, Malte Suchan, Hans Eckel, Philipp Wolber, Shachi J Sharma, Fabian Kämmerer, Christine Langer and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancers, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–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

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Oncologic Outcomes of Transoral Robotic Surgery in HPV-Associated OPSCC: A Systematic Review and Meta-Analysis.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026
    Pooled it
  2. Guideline
  3. Article
  4. 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

15 authors.

Philipp H ZimmermannDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Kerpener Strasse 62, 50931 Cologne, Germany.
Marijn StuutDepartment of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands.
Nora WuerdemannDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Kerpener Strasse 62, 50931 Cologne, Germany.ORCID 0000-0002-1092-689X
Kathrin MöllenhoffDepartment of Mathematics and Computer Science, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands.ORCID 0000-0001-7861-3892
Malte SuchanDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Kerpener Strasse 62, 50931 Cologne, Germany.
Hans EckelDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Kerpener Strasse 62, 50931 Cologne, Germany.
Philipp WolberDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Kerpener Strasse 62, 50931 Cologne, Germany.
Shachi J SharmaDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Kerpener Strasse 62, 50931 Cologne, Germany.
Fabian KämmererDepartment of Ororhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Giessen, Klinikstrasse 33, 35392 Giessen, Germany.
Christine LangerDepartment of Ororhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Giessen, Klinikstrasse 33, 35392 Giessen, Germany.ORCID 0000-0002-0357-2931
Claus WittekindtDepartment of Otorhinolaryngology, Klinikum Dortmund, Beurhausstr. 40, 44137 Dortmund, Germany.
Steffen WagnerDepartment of Ororhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Giessen, Klinikstrasse 33, 35392 Giessen, Germany.ORCID 0000-0003-0873-1601
Bernd KremerDepartment of Ororhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Giessen, Klinikstrasse 33, 35392 Giessen, Germany.
Ernst Jan M SpeelDepartment of Pathology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.ORCID 0000-0002-3016-2989
Jens P KlussmannDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Kerpener Strasse 62, 50931 Cologne, Germany.ORCID 0000-0002-8223-7954

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The two pillars of therapy for oropharyngeal squamous cell carcinoma (OPSCC) are upfront surgery and primary chemoradiotherapy. Substantial regional preferences exist with regard to the selection of treatment. Despite new therapeutic approaches, patient survival remains poor, with an approximate overall survival (OS) rate of 50% at five years. This study was conducted to investigate a potential survival benefit depending on the treatment modality in OPSCC patients. We retrospectively collected data of 853 patients with histologically confirmed OPSCC from the Giessen and Maastricht cancer databases. To identify risk factors affecting survival, a Cox-proportional hazard model was applied to 442 patients with complete data sets. Based on this cohort a matched-pair analysis with 158 patients was performed to compare OS rates of patients treated either with upfront surgery or primary chemoradiation. For the collective cohort, patients treated with upfront surgery had significantly improved OS rates compared to patients treated with primary chemoradiation. In the matched-pair analysis adjusted for patients' T-, N- and HPV-status as well as risk profile, we observed that both treatment approaches offered equivalent OS rates. Our study emphasizes that treatment recommendations should be made whenever possible on the basis of side-effect profiles caused by the therapeutic approach used. To draw further conclusions, results of the ongoing "best of" (NCT2984410) study are eagerly awaited, investigating the functional outcome after treatment of OPSCC patients.

Indexed as

matched-pair analysisoropharyngeal squamous cell carcinomaprimary chemoradiationsurvivaltherapyupfront surgery

Identifiers

PMID34771428
PMCPMC8582414

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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.