Surgery for T1/2N0 Oropharyngeal Carcinoma Is a Better Treatment Option than Radiotherapy - A Long-Term Follow-Up Study from a Single Japanese High-Volume Cancer Center

Sep 24, 2026

Uploaded by Adam

Retrospective analysis evaluates long-term outcomes in 94 patients with early-stage (T1/2N0) oropharyngeal squamous cell carcinoma treated with initial surgery or radiotherapy at a single Japanese high-volume center. Surgery was used in 74 patients (transoral surgery in 57; transcervical pharyngectomy in 17), while 20 received radiotherapy. Five-year overall survival favored surgery (74.9% vs 51.0%, p=0.035), while disease-specific survival and local control trends also favored surgery without reaching significance. Multiple primary cancers occurred frequently (57.4%), all metachronous, supporting initial surgical strategy considering prognosis and comorbidity patterns.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages16

Reading Time40 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Introduction

Article Surgery for T1/2N0 Oropharyngeal Carcinoma Is a Better Treatment Option than Radiotherapy—A Long-Term Follow-Up Study from a Single Japanese High-Volume Cancer Center Masahiro Rokugo 1,2, Takeshi Shinozaki 1, Ryo Ishii 2, Yusuke Ito 1, Shingo Sakashita 3, Genichiro Ishii 4, Takenori Ogawa 5, *, Yukio Katori 2, Kazuto Matsuura 1 and Ryuichi Hayashi 1, * Received: 2 May 2025 Revised: 29 May 2025 Accepted: 30 May 2025 Published: 31 May 2025 Citation: Rokugo, M.; Shinozaki, T.; Ishii, R.; Ito, Y.; Sakashita, S.; Ishii, G.; Ogawa, T.; Katori, Y.; Matsuura, K.; Hayashi, R. Surgery for T1/2N0 Oropharyngeal Carcinoma Is a Better Treatment Option than Radiotherapy—A Long-Term Follow-Up Study from a Single Japanese High-Volume Cancer Center. Cancers 2025, 17, 1862. [https://](https://)[ ](https://)[doi.org/10.3390/cancers17111862](doi.org/10.3390/cancers17111862) [Copyright:](Copyright:) © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://creativecommons.org/](https://creativecommons.org/)[ ](https://creativecommons.org/)[licenses/by/4.0/](licenses/by/4.0/)) . 1 Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa 277-8577, Chiba, Japan; [masahiro.rokugo.c1@tohoku.ac.jp](masahiro.rokugo.c1@tohoku.ac.jp) (M.R.); [tashinoz@east.ncc.go.jp](tashinoz@east.ncc.go.jp) (T.S.); [yusuke19881988@gmail.com](yusuke19881988@gmail.com) (Y.I.); [kmatsuur@east.ncc.go.jp](kmatsuur@east.ncc.go.jp) (K.M.) 2 Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai 980-8574, Miyagi, Japan; [rishii@orl.med.tohoku.ac.jp](rishii@orl.med.tohoku.ac.jp) (R.I.); [yukio.katori.d1@tohoku.ac.jp](yukio.katori.d1@tohoku.ac.jp) (Y.K.) 3 Division of Pathology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center East, Kashiwa 277-8577, Chiba, Japan; [ssakashi@east.ncc.go.jp](ssakashi@east.ncc.go.jp) 4 Department of Pathology and Clinical Laboratories, National Cancer Center Hospital East, Kashiwa 277-8577, Chiba, Japan; [gishii@east.ncc.go.jp](gishii@east.ncc.go.jp) 5 Department of Otolaryngology-Head and Neck Surgery, Gifu University Graduate School of Medicine, Gifu 501-1194, Gifu, Japan * Correspondence: [ogawa.takenori.d2@f.gifu-u.ac.jp](ogawa.takenori.d2@f.gifu-u.ac.jp) (T.O.); [rhayashi@east.ncc.go.jp](rhayashi@east.ncc.go.jp) (R.H.); Tel.: +81-58-230-6279 (T.O.); +81-4-7133-1111 (R.H.) Simple Summary: This retrospective study included 94 cases of early-stage (T1/2N0) oropharyngeal squamous cell carcinoma treated with surgery or radiotherapy. Of these, 74 cases underwent surgery, and 20 cases received radiotherapy. Of the patients who underwent surgery, 57 underwent transoral surgery, and 17 underwent pharyngectomy via transcervical approach. The five-year overall survival was significantly higher in the surgery group compared to radiotherapy (74.9% vs. 51.0%, p = 0.035) . Disease-specific survival and local control rates also favored surgery but did not reach statistical significance. Notably, 57.4% of cases suffered from multiple primary cancers, of which 30.9% were in the head and neck region and all were metachronous. These findings suggest that surgery isan effective initial treatment for early-stage oropharyngeal cancer, which often involves metachronous multiple primary cancers, and contributes to improving prognosis. Abstract: Background: The proportion of oropharyngeal cancers, especially those that are HPV-associated, is increasing, and both surgery and RT are considered effective initial treatments for early-stage oropharyngeal cancer, regardless of p16 status. However, there are still many unknowns regarding the long-term prognosis after initial treatment, the incidence rate of multiple cancers, and the relationship with p16 status. Methods: We retrospectively ana

FAQs

What patient group and treatments were analyzed in this study?

The study retrospectively analyzed 94 cases of T1/2N0 oropharyngeal squamous cell carcinoma treated with either surgery or radiotherapy between January 2000 and December 2012.

How did overall survival compare between surgery and radiotherapy?

Five-year overall survival was significantly higher in the surgery group than in the radiotherapy group (74.9% vs 51.0%, p=0.035).

What role did multiple primary cancers play in the findings?

Multiple primary cancers were present in 57.4% of cases, with 30.9% located in the head and neck region, and all were metachronous—supporting consideration of surgery as an initial strategy.

Sep 24, 2026

Uploaded by Adam