Evidence map›Paper›PMID 39250754›Full record

ArticleJournal of the National Cancer Institute2025

Lower survival for surgical treatment of human papillomavirus-related oropharynx cancer at community cancer centers.

Danielle R Trakimas, Wojciech K Mydlarz, Leila J Mady, Christine G Gourin, Wayne Koch, Nyall R London, Harry Quon, Ana P Kiess, Tanguy Y Seiwert, Carole Fakhry

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the National Cancer Institute, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Danielle R TrakimasDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.ORCID 0000-0003-1974-1880
Wojciech K MydlarzDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Leila J MadyDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Christine G GourinDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Wayne KochDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Nyall R LondonDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Harry QuonDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.ORCID 0000-0001-7605-4329
Ana P KiessDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Tanguy Y SeiwertDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.ORCID 0000-0001-7919-8272
Carole FakhryDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.ORCID 0000-0002-5251-6178

Funding

RESEARCH TRAINING IN OTOLARYNGOLOGYT32DC000027 · NIDCD · JOHNS HOPKINS UNIVERSITY · PI CAREY, JOHN PATRICK · 1989 to 2023
$5.5M
NIDCD NIH HHS T32 DC000027NIH HHS T32DC000027-32
6 · The paper itself

Abstract

backgroundThe rate of primary surgery for human papillomavirus (HPV)-related oropharynx cancer has recently declined, whereas use of transoral robotic surgery has lagged at community cancer centers. We hypothesize that differences in overall survival exist between patients undergoing surgery for HPV-related oropharynx cancer at community centers and low transoral robotic surgery volume (<15 transoral robotic surgeries per year) academic centers and high transoral robotic surgery volume (≥15 transoral robotic surgeries per year) academic centers.

methodsPatients from the US National Cancer Database with a diagnosis of HPV-related oropharynx cancer from 2010 to 2019 who underwent primary surgical treatment were included. Trends in transoral robotic surgery use, rates of positive surgical margins, quality of adjuvant treatment, and 5-year overall survival were compared between community centers, low transoral robotic surgery volume academic centers, and high transoral robotic surgery volume academic centers.

resultsA total of 5406 patients met study criteria. A clinically and statistically significantly lower proportion of patients at community centers underwent transoral robotic surgery than at low transoral robotic surgery volume academic centers or high transoral robotic surgery volume academic centers (26.2% vs 44.0% vs 73.9%, respectively; P < .001). The rate of positive surgical margins was clinically and statistically significantly higher at community centers than at low transoral robotic surgery volume academic centers or high transoral robotic surgery volume academic centers (25.7% vs 15.3% vs 9.2%, respectively; P < .001). A greater proportion of patients undergoing adjuvant radiotherapy (RT) received prolonged courses (23.6% vs 13.1% vs 8.8%; P < .001) or excessive doses (16.5% vs 11.5% vs 8.7%; P < .001) of RT at community centers than at low transoral robotic surgery volume academic centers or high transoral robotic surgery volume academic centers, respectively. Five-year overall survival was lowest at community centers (85.2%, 95% confidence interval [CI] = 81.7% to 88.2%), intermediate at low transoral robotic surgery volume academic centers (88.9%, 95% CI = 87.2% to 90.4%), and highest at high transoral robotic surgery volume academic centers (91.4%, 95% CI = 89.5% to 92.9%; Plog-rank < .01).

conclusionsClinically and statistically significant differences in the type and quality of surgical and adjuvant treatment for HPV-related oropharynx cancer exist between facility types based on transoral robotic surgery volume. Overall survival was lowest at community centers, intermediate at low transoral robotic surgery volume academic centers, and highest at high transoral robotic surgery volume academic centers.

Indexed as

Oropharyngeal NeoplasmsPapillomavirus InfectionsRobotic Surgical ProceduresAcademic Medical CentersAdultAgedCancer Care FacilitiesFemaleHuman Papillomavirus VirusesHumansMaleMargins of ExcisionMiddle AgedPapillomaviridaeSurvival RateUnited States

Identifiers

PMID39250754
PMCPMC11884852

What OpenQuestion holds

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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.