The role of adjuvant treatment in early-stage oral cavity squamous cell carcinoma: An international collaborative study

Eran Fridman, Shorook Na'ara, Jaiprakash Agarwal, Moran Amit, Gideon Bachar, Andrea Bolzoni Villaret, Jose Brandao, Claudio R. Cernea, Pankaj Chaturvedi, Jonathan Clark, Ardalan Ebrahimi, Dan M. Fliss, Sashikanth Jonnalagadda, Hugo F. Kohler, Luiz P. Kowalski, Matthias Kreppel, Chun Ta Liao, Snehal G. Patel, Rajan S. Patel, K. Thomas RobbinsJatin P. Shah, Thomas Shpitzer, Tzu Chen Yen, Joachim E. Zöller, Ziv Gil, for the International Consortium for Outcome Research in Head and Neck Cancer

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)2948-2955
Number of pages8
Issue number14
StatePublished - Jul 15 2018


  • margins
  • oral cavity
  • squamous cell carcinoma
  • survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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