Depth of invasion alone as an indication for postoperative radiotherapy in small oral squamous cell carcinomas: An International Collaborative Study

The International Consortium for Outcome Research (ICOR) in Head and Neck Cancer

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Background: We aimed to investigate whether depth of invasion (DOI) should be an independent indication for postoperative radiotherapy (PORT) in small oral squamous cell carcinomas (SCC). Methods: Retrospective analysis of DOI (<5, 5 to <10, ≥10 mm) and disease-specific survival (DSS) in a multi-institutional international cohort of 1409 patients with oral SCC ≤4 cm in size treated between 1990-2011. Results: In patients without other adverse factors (nodal metastases; close [<5 mm] or involved margins), there was no association between DOI and DSS, with an excellent prognosis irrespective of depth. In the absence of PORT, the 5-year disease-specific mortality was 10% with DOI ≥10 mm, 8% with DOI 5-10 mm, and 6% with DOI <5 mm (P =.169), yielding an absolute risk difference of only 4%. Conclusion: The deterioration in prognosis with increasing DOI largely reflects an association with other adverse features. In the absence of these, depth alone should not be an indication for PORT outside a clinical trial.

Original languageEnglish (US)
Pages (from-to)1935-1942
Number of pages8
JournalHead and Neck
Volume41
Issue number6
DOIs
StatePublished - Jun 2019

Keywords

  • depth of invasion
  • head and neck cancer
  • locoregional control
  • oral squamous cell carcinoma
  • radiotherapy
  • survival
  • tumor thickness

ASJC Scopus subject areas

  • Otorhinolaryngology

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