The role of adjuvant treatment in early‐stage oral cavity squamous cell carcinoma: An international collaborative study
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 stu...
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| Published in | Cancer Vol. 124; no. 14; pp. 2948 - 2955 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Wiley Subscription Services, Inc
15.07.2018
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| Subjects | |
| Online Access | Get full text |
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| 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. © 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. |
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| AbstractList | BACKGROUNDUp 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.METHODSOverall survival (OS), disease‐specific survival, local‐free survival, and disease‐free survival rates were calculated with Kaplan‐Meier analysis.RESULTSOf 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).CONCLUSIONSPatients 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. 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. 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. Overall survival (OS), disease-specific survival, local-free survival, and disease-free survival rates were calculated with Kaplan-Meier analysis. 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). 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. 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.BACKGROUNDUp 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.Overall survival (OS), disease-specific survival, local-free survival, and disease-free survival rates were calculated with Kaplan-Meier analysis.METHODSOverall survival (OS), disease-specific survival, local-free survival, and disease-free survival rates were calculated with Kaplan-Meier analysis.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).RESULTSOf 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).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.CONCLUSIONSPatients 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. |
| Author | Gil, Ziv Cernea, Claudio R. Robbins, K. Thomas Chaturvedi, Pankaj Yen, Tzu‐Chen Na'ara, Shorook Patel, Rajan S. Villaret, Andrea Bolzoni Jonnalagadda, Sashikanth Agarwal, Jaiprakash Shpitzer, Thomas Amit, Moran Bachar, Gideon Liao, Chun‐Ta Kreppel, Matthias Kowalski, Luiz P. Ebrahimi, Ardalan Shah, Jatin P. Fridman, Eran Zöller, Joachim E. Clark, Jonathan Brandao, Jose Kohler, Hugo F. Fliss, Dan M. Patel, Snehal G. |
| AuthorAffiliation | 2 Laboratory for Applied Cancer Research, Technion–Israel Institute of Technology, Haifa, Israel 1 Rambam Healthcare Campus, Technion–Israel Institute of Technology, Haifa, Israel 9 University of New South Wales, Sydney, New South Wales, Australia 13 A. C. Camargo Cancer Center, São Paulo, Brazil 12 Department of Head and Neck Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil 14 Department of Oral and Cranio-Maxillo and Facial Plastic Surgery, University of Cologne, Cologne, Germany 6 Department of Head and Neck Surgery, University of São Paulo Medical School, São Paulo, Brazil 7 Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia 4 Department of Otolaryngology–Head and Neck Surgery, Rabin Medical Center, Petach Tikva, Israel 11 Southern Illinois University School of Medicine, Springfield, Illinois 10 Department of Otolaryngology–Head and Neck Surgery, Tel Aviv Medical Center, Tel Aviv, Israel 15 Chang Gung Memorial Hospital, Taoyuan, Taiw |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29757457$$D View this record in MEDLINE/PubMed |
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| Keywords | oral cavity margins survival squamous cell carcinoma |
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| Notes | We thank Cindy Cohen for her editorial assistance and Anat Reiner Benaim, PhD, for her statistical analysis and support. The authors are members of the Oral Cancer International Study Group. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 AUTHOR CONTRIBUTIONS Eran Fridman: Conceptualization, data curation, formal analysis, methodology, project administration, resources, software, supervision, validation, visualization, writing–original draft, and writing–review and editing. Shorook Na’ara: Conceptualization, visualization, and writing–review and editing. Jaiprakash Agarwal: Resources and writing–review and editing. Moran Amit: Writing–review and editing. Gideon Bachar: Resources and writing–review and editing. Andrea Bolzoni Villaret: Writing–review and editing. Jose Brandao: Writing–review and editing. Claudio R. Cernea: Resources and writing–review and editing. Pankaj Chaturvedi: Writing–review and editing. Jonathan Clark: Writing–review and editing. Ardalan Ebrahimi: Resources and writing–review and editing. Dan M. Fliss: Resources and writing–review and editing. Sashikanth Jonnalagadda: Resources and writing–review and editing. Hugo F. Kohler: Writing–review and editing. Luiz P. Kowalski: Resources and writing–review and editing. Matthias Kreppel: Writing–review and editing. Chun-Ta Liao: Resources and writing–review and editing. Snehal G. Patel: Resources and writing–review and editing. Rajan S. Patel: Writing–review and editing. K. Thomas Robbins: Writing–review and editing. Jatin P. Shah: Writing–review and editing. Thomas Shpitzer: Writing–review and editing. Tzu-Chen Yen: Writing–review and editing. Joachim E. Zöller: Writing–review and editing. Ziv Gil: Conceptualization, data curation, formal analysis, methodology, project administration, resources, software, supervision, validation, visualization, writing–original draft, and writing–review and editing. |
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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... Patients with stage I to II oral cavity squamous cell carcinoma and positive/close margins have poor long‐term outcomes. For this population, adjuvant... 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... BACKGROUNDUp to half of patients with oral cavity squamous cell carcinoma (OCSCC) have stage I to II disease. When adequate resection is attained, no further... |
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| SubjectTerms | 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 |
| Title | The role of adjuvant treatment in early‐stage oral cavity squamous cell carcinoma: An international collaborative study |
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