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 Robbins; Jatin P. Shah; Thomas Shpitzer; Tzu Chen Yen; Joachim E. Zöller; Ziv Gil; for the International Consortium for Outcome Research in Head and Neck Cancer

doi:10.1002/cncr.31531

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

Houston Methodist

Research output: Contribution to journal › Article › peer-review

54 Scopus citations

Abstract

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 language	English (US)
Pages (from-to)	2948-2955
Number of pages	8
Journal	Cancer
Volume	124
Issue number	14
DOIs	https://doi.org/10.1002/cncr.31531
State	Published - Jul 15 2018

Keywords

margins
oral cavity
squamous cell carcinoma
survival

ASJC Scopus subject areas

Oncology
Cancer Research

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10.1002/cncr.31531

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Fridman, E., Na'ara, S., Agarwal, J., Amit, M., Bachar, G., Villaret, A. B., Brandao, J., Cernea, C. R., Chaturvedi, P., Clark, J., Ebrahimi, A., Fliss, D. M., Jonnalagadda, S., Kohler, H. F., Kowalski, L. P., Kreppel, M., Liao, C. T., Patel, S. G., Patel, R. S., ... for the International Consortium for Outcome Research in Head and Neck Cancer (2018). The role of adjuvant treatment in early-stage oral cavity squamous cell carcinoma: An international collaborative study. Cancer, 124(14), 2948-2955. https://doi.org/10.1002/cncr.31531

Fridman, E, Na'ara, S, Agarwal, J, Amit, M, Bachar, G, Villaret, AB, Brandao, J, Cernea, CR, Chaturvedi, P, Clark, J, Ebrahimi, A, Fliss, DM, Jonnalagadda, S, Kohler, HF, Kowalski, LP, Kreppel, M, Liao, CT, Patel, SG, Patel, RS, Robbins, KT, Shah, JP, Shpitzer, T, Yen, TC, Zöller, JE, Gil, Z & for the International Consortium for Outcome Research in Head and Neck Cancer 2018, 'The role of adjuvant treatment in early-stage oral cavity squamous cell carcinoma: An international collaborative study', Cancer, vol. 124, no. 14, pp. 2948-2955. https://doi.org/10.1002/cncr.31531

@article{0562a487152949fc82a06755aad0e81f,

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

abstract = "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.",

keywords = "margins, oral cavity, squamous cell carcinoma, survival",

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

note = "Funding Information: This work was supported by the Israel Science Foundation and the Israel Cancer Association. Publisher Copyright: {\textcopyright} 2018 American Cancer Society",

year = "2018",

month = jul,

day = "15",

doi = "10.1002/cncr.31531",

language = "English (US)",

volume = "124",

pages = "2948--2955",

journal = "Cancer",

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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

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DO - 10.1002/cncr.31531

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JO - Cancer

JF - Cancer

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

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