Comparing the Effectiveness of Non-Surgical and Surgical Treatment Modalities in the Management of Oropharyngeal Carcinoma: A Systematic Review and Meta-Analysis

Abstract

Objectives: To answer the question, “how effective are nonsurgical treatment modalities compared to any form of surgical intervention (with or without adjunct treatments) in the management of oropharyngeal carcinoma (OPC)?” Data Sources: We conducted systematic searches for Randomized Controlled Trials and Controlled Clinical Trials in PubMed, Cochrane, Ovid Medline, and OpenGrey databases. The US National Institutes of Health Ongoing Trials Register and the World Health Organization International Clinical Trials Registry Platform were also searched for ongoing and past studies. Identified studies were retrieved and assessed for relevance. Review Methods: The primary outcomes assessed in the trials had to include any combination of overall survival, disease-free survival, locoregional control, and recurrence. While secondary outcomes considered were complications of treatment, participants’ satisfaction, costs to participants and health services, and quality of life. Results: Only 5 studies met all inclusion criteria and were selected for qualitative analysis. One compared radiotherapy with surgery, 2 compared chemoradiotherapy with surgery, and 2 compared chemoradiotherapy with transoral robotic surgery. Conclusion: Based on results from this review, surgery is the mainstay of OPC management. However, concurrent chemoradiotherapy is a viable alternative in patients with unresectable disease or disease difficult to access due to location, patients with advanced disease intolerant of surgery, and in patients who do not consent to surgery.