Head & Neck / Thyroid Oncology Research Updates

In 107 consecutive patients with HPV-positive oropharyngeal squamous cell carcinoma treated with transoral robotic surgery and retropharyngeal lymph node (RPLN) dissection, 25.2% had pathologic RPLN metastases. Preoperative imaging had low sensitivity (53.8%) but high specificity (91.8%) and was the only independent predictor of pathologic RPLN; with multidisciplinary management including RPLN dissection and adjuvant therapy, RPLN positivity trended toward but was not significantly associated with worse 5-year DFS or OS (DFS 84.4%, OS 86.3%).

In a multicenter, open-label randomized trial of 173 patients with heavily pretreated, immunotherapy-exposed recurrent/metastatic nasopharyngeal carcinoma, patients received becotatug vedotin versus chemotherapy (capecitabine or docetaxel). Becotatug vedotin produced a higher objective response rate (30.2% vs 11.5%; P=0.003) and longer median progression-free survival (5.82 vs 2.83 months; HR 0.63, 95% CI 0.43–0.91; P=0.01), with comparable safety and an interim overall survival signal favoring the investigational drug that was not statistically significant (median OS 17.08 vs 11.99 months; HR 0.73, 95% CI 0.48–1.12; P=0.15).

Using a retrospective TriNetX cohort of 1,592 adults undergoing transoral robotic surgery (TORS) for oropharyngeal squamous cell carcinoma, investigators derived the TORS Severe Outcome Score (TSOS) to predict a composite 30‑day severe postoperative outcome (hemorrhage, tracheostomy, or gastrostomy), which occurred in 15.7% of patients. Independent preoperative predictors were advanced T stage (T3/T4), BMI <22, smoking, preoperative dysphagia, and hyperlipidemia, and a score threshold ≥24 showed the best discrimination for the composite outcome; the score requires external validation.