Depth of invasion alone as an indication for postoperative radiotherapy in small oral squamous cell carcinomas: An International Collaborative Study
Background We aimed to investigate whether depth of invasion (DOI) should be an independent indication for postoperative radiotherapy (PORT) in small oral squamous cell carcinomas (SCC). Methods Retrospective analysis of DOI (<5, 5 to <10, ≥10 mm) and disease‐specific survival (DSS) in a multi...
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| Published in | Head & neck Vol. 41; no. 6; pp. 1935 - 1942 |
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| Main Authors | , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
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Hoboken, USA
John Wiley & Sons, Inc
01.06.2019
Wiley Subscription Services, Inc |
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| Abstract | Background
We aimed to investigate whether depth of invasion (DOI) should be an independent indication for postoperative radiotherapy (PORT) in small oral squamous cell carcinomas (SCC).
Methods
Retrospective analysis of DOI (<5, 5 to <10, ≥10 mm) and disease‐specific survival (DSS) in a multi‐institutional international cohort of 1409 patients with oral SCC ≤4 cm in size treated between 1990‐2011.
Results
In patients without other adverse factors (nodal metastases; close [<5 mm] or involved margins), there was no association between DOI and DSS, with an excellent prognosis irrespective of depth. In the absence of PORT, the 5‐year disease‐specific mortality was 10% with DOI ≥10 mm, 8% with DOI 5‐10 mm, and 6% with DOI <5 mm (P = .169), yielding an absolute risk difference of only 4%.
Conclusion
The deterioration in prognosis with increasing DOI largely reflects an association with other adverse features. In the absence of these, depth alone should not be an indication for PORT outside a clinical trial. |
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| AbstractList | We aimed to investigate whether depth of invasion (DOI) should be an independent indication for postoperative radiotherapy (PORT) in small oral squamous cell carcinomas (SCC).
Retrospective analysis of DOI (<5, 5 to <10, ≥10 mm) and disease-specific survival (DSS) in a multi-institutional international cohort of 1409 patients with oral SCC ≤4 cm in size treated between 1990-2011.
In patients without other adverse factors (nodal metastases; close [<5 mm] or involved margins), there was no association between DOI and DSS, with an excellent prognosis irrespective of depth. In the absence of PORT, the 5-year disease-specific mortality was 10% with DOI ≥10 mm, 8% with DOI 5-10 mm, and 6% with DOI <5 mm (P = .169), yielding an absolute risk difference of only 4%.
The deterioration in prognosis with increasing DOI largely reflects an association with other adverse features. In the absence of these, depth alone should not be an indication for PORT outside a clinical trial. BackgroundWe aimed to investigate whether depth of invasion (DOI) should be an independent indication for postoperative radiotherapy (PORT) in small oral squamous cell carcinomas (SCC).MethodsRetrospective analysis of DOI (<5, 5 to <10, ≥10 mm) and disease‐specific survival (DSS) in a multi‐institutional international cohort of 1409 patients with oral SCC ≤4 cm in size treated between 1990‐2011.ResultsIn patients without other adverse factors (nodal metastases; close [<5 mm] or involved margins), there was no association between DOI and DSS, with an excellent prognosis irrespective of depth. In the absence of PORT, the 5‐year disease‐specific mortality was 10% with DOI ≥10 mm, 8% with DOI 5‐10 mm, and 6% with DOI <5 mm (P = .169), yielding an absolute risk difference of only 4%.ConclusionThe deterioration in prognosis with increasing DOI largely reflects an association with other adverse features. In the absence of these, depth alone should not be an indication for PORT outside a clinical trial. We aimed to investigate whether depth of invasion (DOI) should be an independent indication for postoperative radiotherapy (PORT) in small oral squamous cell carcinomas (SCC).BACKGROUNDWe aimed to investigate whether depth of invasion (DOI) should be an independent indication for postoperative radiotherapy (PORT) in small oral squamous cell carcinomas (SCC).Retrospective analysis of DOI (<5, 5 to <10, ≥10 mm) and disease-specific survival (DSS) in a multi-institutional international cohort of 1409 patients with oral SCC ≤4 cm in size treated between 1990-2011.METHODSRetrospective analysis of DOI (<5, 5 to <10, ≥10 mm) and disease-specific survival (DSS) in a multi-institutional international cohort of 1409 patients with oral SCC ≤4 cm in size treated between 1990-2011.In patients without other adverse factors (nodal metastases; close [<5 mm] or involved margins), there was no association between DOI and DSS, with an excellent prognosis irrespective of depth. In the absence of PORT, the 5-year disease-specific mortality was 10% with DOI ≥10 mm, 8% with DOI 5-10 mm, and 6% with DOI <5 mm (P = .169), yielding an absolute risk difference of only 4%.RESULTSIn patients without other adverse factors (nodal metastases; close [<5 mm] or involved margins), there was no association between DOI and DSS, with an excellent prognosis irrespective of depth. In the absence of PORT, the 5-year disease-specific mortality was 10% with DOI ≥10 mm, 8% with DOI 5-10 mm, and 6% with DOI <5 mm (P = .169), yielding an absolute risk difference of only 4%.The deterioration in prognosis with increasing DOI largely reflects an association with other adverse features. In the absence of these, depth alone should not be an indication for PORT outside a clinical trial.CONCLUSIONThe deterioration in prognosis with increasing DOI largely reflects an association with other adverse features. In the absence of these, depth alone should not be an indication for PORT outside a clinical trial. Background We aimed to investigate whether depth of invasion (DOI) should be an independent indication for postoperative radiotherapy (PORT) in small oral squamous cell carcinomas (SCC). Methods Retrospective analysis of DOI (<5, 5 to <10, ≥10 mm) and disease‐specific survival (DSS) in a multi‐institutional international cohort of 1409 patients with oral SCC ≤4 cm in size treated between 1990‐2011. Results In patients without other adverse factors (nodal metastases; close [<5 mm] or involved margins), there was no association between DOI and DSS, with an excellent prognosis irrespective of depth. In the absence of PORT, the 5‐year disease‐specific mortality was 10% with DOI ≥10 mm, 8% with DOI 5‐10 mm, and 6% with DOI <5 mm (P = .169), yielding an absolute risk difference of only 4%. Conclusion The deterioration in prognosis with increasing DOI largely reflects an association with other adverse features. In the absence of these, depth alone should not be an indication for PORT outside a clinical trial. |
| Author | Gil, Ziv Kreppel, Matthias Kowalski, Luiz P. Ebrahimi, Ardalan Shah, Jatin P. Cernea, Claudio R. Fridman, Eran Agarwal, Jai Prakash Chaturvedi, Pankaj Yen, Tzu‐Chen Robbins, Kevin Thomas Köhler, Hugo F. Villaret, Andrea Bolzoni Brandao, Jason Fliss, Dan M. Amit, Moran Bachar, Gideon Clark, Jonathan R. Liao, Chun‐ta Patel, Snehal G. |
| Author_xml | – sequence: 1 givenname: Ardalan orcidid: 0000-0002-5433-3965 surname: Ebrahimi fullname: Ebrahimi, Ardalan email: ardalan@specialistheadandneck.com organization: College of Health and Medicine, Australian National University – sequence: 2 givenname: Ziv orcidid: 0000-0001-5390-9507 surname: Gil fullname: Gil, Ziv organization: Rappaport School of Medicine, the Technion, Israel institute of technology – sequence: 3 givenname: Moran orcidid: 0000-0002-9720-7766 surname: Amit fullname: Amit, Moran organization: Rappaport School of Medicine, the Technion, Israel institute of technology – sequence: 4 givenname: Tzu‐Chen orcidid: 0000-0002-6136-0486 surname: Yen fullname: Yen, Tzu‐Chen organization: Chang Gung Memorial Hospital – sequence: 5 givenname: Chun‐ta surname: Liao fullname: Liao, Chun‐ta organization: Chang Gung Memorial Hospital – sequence: 6 givenname: Pankaj orcidid: 0000-0002-3520-1342 surname: Chaturvedi fullname: Chaturvedi, Pankaj organization: Tata Memorial Hospital – sequence: 7 givenname: Jai Prakash surname: Agarwal fullname: Agarwal, Jai Prakash organization: Tata Memorial Hospital – sequence: 8 givenname: Luiz P. surname: Kowalski fullname: Kowalski, Luiz P. organization: Hospital A.C. Camargo – sequence: 9 givenname: Hugo F. surname: Köhler fullname: Köhler, Hugo F. organization: Hospital A.C. Camargo – sequence: 10 givenname: Matthias orcidid: 0000-0002-4475-7457 surname: Kreppel fullname: Kreppel, Matthias organization: University of Cologne – sequence: 11 givenname: Claudio R. surname: Cernea fullname: Cernea, Claudio R. organization: University of São Paulo Medical School – sequence: 12 givenname: Jason surname: Brandao fullname: Brandao, Jason organization: University of São Paulo Medical School – sequence: 13 givenname: Gideon surname: Bachar fullname: Bachar, Gideon organization: Rabin Medical Center – sequence: 14 givenname: Andrea Bolzoni surname: Villaret fullname: Villaret, Andrea Bolzoni organization: University of Brescia – sequence: 15 givenname: Dan M. surname: Fliss fullname: Fliss, Dan M. organization: Tel Aviv Medical Center – sequence: 16 givenname: Eran surname: Fridman fullname: Fridman, Eran organization: Tel Aviv Medical Center – sequence: 17 givenname: Kevin Thomas surname: Robbins fullname: Robbins, Kevin Thomas organization: Southern Illinois University School of Medicine – sequence: 18 givenname: Jatin P. orcidid: 0000-0002-6444-6592 surname: Shah fullname: Shah, Jatin P. organization: Memorial Sloan‐Kettering Cancer Center – sequence: 19 givenname: Snehal G. surname: Patel fullname: Patel, Snehal G. organization: Memorial Sloan‐Kettering Cancer Center – sequence: 20 givenname: Jonathan R. surname: Clark fullname: Clark, Jonathan R. organization: Sydney University |
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We aimed to investigate whether depth of invasion (DOI) should be an independent indication for postoperative radiotherapy (PORT) in small oral... We aimed to investigate whether depth of invasion (DOI) should be an independent indication for postoperative radiotherapy (PORT) in small oral squamous cell... BackgroundWe aimed to investigate whether depth of invasion (DOI) should be an independent indication for postoperative radiotherapy (PORT) in small oral... |
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| SubjectTerms | depth of invasion Head & neck cancer Head and neck head and neck cancer locoregional control Medical prognosis Metastases Oral cancer Oral carcinoma Oral squamous cell carcinoma Prognosis Radiation therapy radiotherapy Squamous cell carcinoma survival tumor thickness |
| Title | Depth of invasion alone as an indication for postoperative radiotherapy in small oral squamous cell carcinomas: An International Collaborative Study |
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