TY - JOUR
T1 - Depth of invasion alone as an indication for postoperative radiotherapy in small oral squamous cell carcinomas
T2 - An International Collaborative Study
AU - The International Consortium for Outcome Research (ICOR) in Head and Neck Cancer
AU - Ebrahimi, Ardalan
AU - Gil, Ziv
AU - Amit, Moran
AU - Yen, Tzu Chen
AU - Liao, Chun ta
AU - Chaturvedi, Pankaj
AU - Agarwal, Jai Prakash
AU - Kowalski, Luiz P.
AU - Köhler, Hugo F.
AU - Kreppel, Matthias
AU - Cernea, Claudio R.
AU - Brandao, Jason
AU - Bachar, Gideon
AU - Villaret, Andrea Bolzoni
AU - Fliss, Dan M.
AU - Fridman, Eran
AU - Robbins, Kevin Thomas
AU - Shah, Jatin P.
AU - Patel, Snehal G.
AU - Clark, Jonathan R.
N1 - Publisher Copyright:
© 2019 Wiley Periodicals, Inc.
PY - 2019/6
Y1 - 2019/6
N2 - 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.
AB - 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.
KW - depth of invasion
KW - head and neck cancer
KW - locoregional control
KW - oral squamous cell carcinoma
KW - radiotherapy
KW - survival
KW - tumor thickness
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U2 - 10.1002/hed.25633
DO - 10.1002/hed.25633
M3 - Article
C2 - 30801885
AN - SCOPUS:85062373816
VL - 41
SP - 1935
EP - 1942
JO - Head and Neck Surgery
JF - Head and Neck Surgery
SN - 1043-3074
IS - 6
ER -