Gastrostomy tube dependence and patient‐reported quality of life outcomes based on type of treatment for human papillomavirus‐associated oropharyngeal cancer: Systematic review and meta‐analysis

We examined the impact of treatment modality on gastrostomy tube dependence and patient‐reported outcomes in human papillomavirus‐associated oropharyngeal cancer (HPV‐OPSCC). We performed systematic review and meta‐analysis of functional outcomes 1–3 years after treatment. Twenty‐three studies were included, reporting on 3127 patients treated for HPV‐OPSCC. Gastrostomy tube dependence failed to show statistically significant difference between surgery with adjuvant therapy and chemoradiotherapy with cisplatin at 12 months (8.3% [95% CI: 3.1–15.9] vs. 4.2% [1.1–9.2], p = 0.37) and 24–36 months (10.5% [95% CI: 3.2–21.5] vs. 3.3% [2.0–4.9], p = 0.06). Surgery with adjuvant therapy was associated with worse University of Washington Quality of Life (UW‐QOL) Swallowing (84 [95% CI: 80–88] vs. 89 [87–90], p = 0.03) and UW‐QOL Overall scores (76 [95% CI: 72–80] vs. 84 [81–86], p = 0.001) compared to chemoradiotherapy with cisplatin at 12 months. Surgery with adjuvant therapy was associated with worse performance on certain measures of patient‐reported swallow and overall function compared to chemoradiotherapy with cisplatin. Further randomized controlled trials are needed to directly compare functional outcomes after treatment for HPV‐OPSCC.