TY - JOUR
T1 - The role of adjuvant treatment in early-stage oral cavity squamous cell carcinoma
T2 - An international collaborative study
AU - Fridman, Eran
AU - Na'ara, Shorook
AU - Agarwal, Jaiprakash
AU - Amit, Moran
AU - Bachar, Gideon
AU - Villaret, Andrea Bolzoni
AU - Brandao, Jose
AU - Cernea, Claudio R.
AU - Chaturvedi, Pankaj
AU - Clark, Jonathan
AU - Ebrahimi, Ardalan
AU - Fliss, Dan M.
AU - Jonnalagadda, Sashikanth
AU - Kohler, Hugo F.
AU - Kowalski, Luiz P.
AU - Kreppel, Matthias
AU - Liao, Chun Ta
AU - Patel, Snehal G.
AU - Patel, Rajan S.
AU - Robbins, K. Thomas
AU - Shah, Jatin P.
AU - Shpitzer, Thomas
AU - Yen, Tzu Chen
AU - Zöller, Joachim E.
AU - Gil, Ziv
AU - for the International Consortium for Outcome Research in Head and Neck Cancer
PY - 2018/7/15
Y1 - 2018/7/15
N2 - BACKGROUND: Up to half of patients with oral cavity squamous cell carcinoma (OCSCC) have stage I to II disease. When adequate resection is attained, no further treatment is needed; however, re-resection or radiotherapy may be indicated for patients with positive or close margins. This multicenter study evaluated the outcomes and role of adjuvant treatment in patients with stage I to II OCSCC. METHODS: Overall survival (OS), disease-specific survival, local-free survival, and disease-free survival rates were calculated with Kaplan-Meier analysis. RESULTS: Of 1257 patients with T1-2N0M0 disease, 33 (2.6%) had positive margins, and 205 (16.3%) had close margins. The 5-year OS rate was 80% for patients with clear margins, 52% for patients with close margins, and 63% for patients with positive margins (P <.0001). In a multivariate analysis, age, depth of invasion, and margins were independent predictors of outcome. Close margins were associated with a >2-fold increase in the risk of recurrence (P <.0001). The multivariate analysis revealed that adjuvant treatment significantly improved the outcomes of patients with close/positive margins (P =.002 to.03). CONCLUSIONS: Patients with stage I to II OCSCC and positive/close margins have poor long-term outcomes. For this population, adjuvant treatment may be associated with improved survival. Cancer 2018;124:2948-55.
AB - BACKGROUND: Up to half of patients with oral cavity squamous cell carcinoma (OCSCC) have stage I to II disease. When adequate resection is attained, no further treatment is needed; however, re-resection or radiotherapy may be indicated for patients with positive or close margins. This multicenter study evaluated the outcomes and role of adjuvant treatment in patients with stage I to II OCSCC. METHODS: Overall survival (OS), disease-specific survival, local-free survival, and disease-free survival rates were calculated with Kaplan-Meier analysis. RESULTS: Of 1257 patients with T1-2N0M0 disease, 33 (2.6%) had positive margins, and 205 (16.3%) had close margins. The 5-year OS rate was 80% for patients with clear margins, 52% for patients with close margins, and 63% for patients with positive margins (P <.0001). In a multivariate analysis, age, depth of invasion, and margins were independent predictors of outcome. Close margins were associated with a >2-fold increase in the risk of recurrence (P <.0001). The multivariate analysis revealed that adjuvant treatment significantly improved the outcomes of patients with close/positive margins (P =.002 to.03). CONCLUSIONS: Patients with stage I to II OCSCC and positive/close margins have poor long-term outcomes. For this population, adjuvant treatment may be associated with improved survival. Cancer 2018;124:2948-55.
KW - margins
KW - oral cavity
KW - squamous cell carcinoma
KW - survival
UR - http://www.scopus.com/inward/record.url?scp=85049570164&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85049570164&partnerID=8YFLogxK
U2 - 10.1002/cncr.31531
DO - 10.1002/cncr.31531
M3 - Article
AN - SCOPUS:85049570164
VL - 124
SP - 2948
EP - 2955
JO - Cancer
JF - Cancer
SN - 0008-543X
IS - 14
ER -