{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T07:16:12Z","timestamp":1793862972272,"version":"4.6.1"},"reference-count":5,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"23","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2025,8,10]]},"abstract":"<jats:p>This phase II trial of transoral surgery (TOS) with deintensified postoperative management in human papillomavirus (HPV)\u2013associated oropharynx cancer (OPC) enrolled patients with resectable cT1-2 stage III\/IV American Joint Committee on Cancer (AJCC) seventh edition p16+ OPC without matted neck nodes. Those with clear margins, 0-1 + nodes (LN), and no extranodal extension (ENE) were observed (arm A); those with clear margins, 2-4 + LN, or ENE \u22641 mm were randomly assigned to 50 Gy (arm B) or 60 Gy (arm C); and those with involved margins, &gt;4 + LN, or &gt;1 mm ENE received weekly cisplatin and 60-66 Gy (arm D). Among 359 evaluable patients, the 54-month progression-free (PFS) and overall survival (OS) were 90.6% (90% CI, 87.2% to 93.1%) and 95.3% (93.0% to 96.9%), respectively. The 54-month PFS by arm was A 93.2% (79.6% to 97.8%; all four recurrences among N1 patients), B 94.9% (89.7% to 97.5%), C 90.2% (82.7% to 94.6%), and D 85.5% (77.5% to 90.8%). The 54-month OS by arm was A 97.1% (85.7% to 99.4%), B 97.9% (93.5% to 99.3%), C 95.1% (90.1% to 97.6%), and D 92.5% (86.9% to 95.7%). PFS or OS did not differ by primary site or smoking history. TOS and neck dissection with deintensified postoperative management results in outstanding 54-month PFS and OS. Among patients with favorable pathologic characteristics, those with N1 disease are at risk of late recurrence without radiation.<\/jats:p>","DOI":"10.1200\/jco-24-02550","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T15:59:10Z","timestamp":1749571150000},"page":"2559-2565","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":27,"title":["Long-Term Follow-Up of E3311, an ECOG-ACRIN Cancer Research Group Phase II Trial of Transoral Surgery and Risk-Based Adjuvant Treatment in Human Papillomavirus\u2013Initiated Oropharynx Cancer"],"prefix":"10.1200","volume":"43","clinical-trial-number":[{"clinical-trial-number":"nct01898494","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4660-1859","authenticated-orcid":true,"given":"Barbara","family":"Burtness","sequence":"first","affiliation":[{"name":"Department of Medicine, Yale Cancer Center, Yale School of Medicine, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2150-6732","authenticated-orcid":true,"given":"Yael","family":"Flamand","sequence":"additional","affiliation":[{"name":"ECOG-ACRIN Biostatistics Center, Dana-Farber Cancer Institute, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7605-4329","authenticated-orcid":true,"given":"Harry","family":"Quon","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology and Molecular Radiation Sciences. Johns Hopkins University School of Medicine, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory S.","family":"Weinstein","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2477-9584","authenticated-orcid":true,"given":"Ranee","family":"Mehra","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Maryland Greenebaum Comprehensive Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaquin J.","family":"Garcia","sequence":"additional","affiliation":[{"name":"Department of Pathology, Mayo Clinic, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seungwon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Bert W.","family":"O'Malley","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA"},{"name":"The University of Maryland Medical Center, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enver","family":"Ozer","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Ohio State University School of Medicine, Columbus, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4081-2719","authenticated-orcid":true,"given":"Chukwuemeka","family":"Ikpeazu","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Miami School of Medicine, Miami, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayne M.","family":"Koch","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9427-0743","authenticated-orcid":true,"given":"Neil D.","family":"Gross","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, M. D. Anderson Cancer Center, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3775-109X","authenticated-orcid":true,"given":"R. Bryan","family":"Bell","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology, Providence Cancer Institute, Portland, OR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihir","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Emory University School of Medicine, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0736-7473","authenticated-orcid":true,"given":"Miriam N.","family":"Lango","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, M. D. Anderson Cancer Center, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4417-2280","authenticated-orcid":true,"given":"Luc G.","family":"Morris","sequence":"additional","affiliation":[{"name":"Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Nebraska Medical Center, Omaha, NE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Karakla","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Sentara Norfolk General Hospital, Norfolk, VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy D.","family":"Richmon","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Massachusetts Eye and Ear Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9594-1414","authenticated-orcid":true,"given":"Floyd C.","family":"Holsinger","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6605-2071","authenticated-orcid":true,"given":"Robert L.","family":"Ferris","sequence":"additional","affiliation":[{"name":"Lineberger Cancer Center and Department of Otolaryngology, University of North Carolina, Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.32481\/djph.2023.04.008"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.01752"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0912217"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32779-X"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.68.3300"}],"container-title":["Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JCO-24-02550","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T21:59:25Z","timestamp":1754517565000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JCO-24-02550"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,10]]},"references-count":5,"journal-issue":{"issue":"23","published-print":{"date-parts":[[2025,8,10]]}},"alternative-id":["10.1200\/JCO-24-02550"],"URL":"https:\/\/doi.org\/10.1200\/jco-24-02550","relation":{},"ISSN":["0732-183X","1527-7755"],"issn-type":[{"value":"0732-183X","type":"print"},{"value":"1527-7755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,10]]},"assertion":[{"value":"2024-11-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-25","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}