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

• Published in: Cancer Vol. 124; no. 14; pp. 2948 - 2955
• Main Authors: Fridman, Eran, Na'ara, Shorook, Agarwal, Jaiprakash, Amit, Moran, Bachar, Gideon, Villaret, Andrea Bolzoni, Brandao, Jose, Cernea, Claudio R., Chaturvedi, Pankaj, Clark, Jonathan, Ebrahimi, Ardalan, Fliss, Dan M., Jonnalagadda, Sashikanth, Kohler, Hugo F., Kowalski, Luiz P., Kreppel, Matthias, Liao, Chun‐Ta, Patel, Snehal G., Patel, Rajan S., Robbins, K. Thomas, Shah, Jatin P., Shpitzer, Thomas, Yen, Tzu‐Chen, Zöller, Joachim E., Gil, Ziv
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 15.07.2018
• Subjects: Adjuvant therapy; Adult; Aged; Cancer; Chemoradiotherapy, Adjuvant - methods; Disease-Free Survival; Female; Humans; International Cooperation; Kaplan-Meier Estimate; Male; margins; Margins of Excision; Middle Aged; Mouth - pathology; Mouth - surgery; Mouth Neoplasms - mortality; Mouth Neoplasms - pathology; Mouth Neoplasms - therapy; Multivariate analysis; Neoplasm Invasiveness; Neoplasm Recurrence, Local - epidemiology; Neoplasm Recurrence, Local - prevention & control; Neoplasm Staging; Oncology; Oral cavity; Patients; Prognosis; Radiation therapy; Radiotherapy, Adjuvant - methods; Retreatment - statistics & numerical data; Retrospective Studies; Squamous cell carcinoma; Squamous Cell Carcinoma of Head and Neck - mortality; Squamous Cell Carcinoma of Head and Neck - pathology; Squamous Cell Carcinoma of Head and Neck - therapy; Survival; oral cavity; margins; survival; squamous cell carcinoma
• ISSN: 0008-543X; 1097-0142; 1097-0142
• DOI: 10.1002/cncr.31531

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. © 2018 American Cancer Society. Patients with stage I to II oral cavity squamous cell carcinoma and positive/close margins have poor long‐term outcomes. For this population, adjuvant treatment is associated with improved survival.