Parameters to assess the necessity of adjuvant therapy for early‐stage oral squamous cell carcinoma

Author:

Lu Hsueh‐Ju12ORCID,Chiu Yu‐Wei34,Peng Chih‐Yu34,Tseng Hsien‐Chun25,Hsin Chung‐Han26,Chuang Chun‐Yi26,Fan Sheng12,Huang Wei‐Shiou12,Yang Shun‐Fa78ORCID

Affiliation:

1. Division of Hematology and Oncology, Department of Internal Medicine Chung Shan Medical University Hospital Taichung Taiwan

2. School of Medicine Chung Shan Medical University Taichung Taiwan

3. Department of Dentistry Chung Shan Medical University Hospital Taichung Taiwan

4. School of Dentistry Chung Shan Medical University Taichung Taiwan

5. Department of Radiation Oncology Chung Shan Medical University Hospital Taichung Taiwan

6. Department of Otolaryngology Chung Shan Medical University Hospital Taichung Taiwan

7. Institute of Medicine Chung Shan Medical University Taichung Taiwan

8. Department of Medical Research Chung Shan Medical University Hospital Taichung Taiwan

Abstract

AbstractObjectiveOne‐third of head and neck squamous cell carcinomas are early‐stage oral cavity squamous cell carcinomas (OCSCC). Despite a high curative rate, 20% of early‐stage OCSCC patients do not achieve long‐term survival. This study evaluates the role of adjuvant therapy (ADJ) in delaying disease progression and prolonging survival.MethodsThis single‐institute retrospective cohort study enrolled 481 early‐stage OCSCC patients, 16% (78/481) of whom received ADJ. It was reported according to the STROBE guidelines. Cox proportional hazards regression and Kaplan–Meier survival curves were employed to identify suitable candidates for ADJ.ResultsThe 5‐year locoregional recurrence‐free survival (LR‐RFS) and overall survival rates were 73.2% and 84.9%, respectively. Positive margins and advanced depth of invasion (DOI) were independent predictors of LR‐RFS. For patients with positive margins, adjuvant chemoradiotherapy (CRT) was superior to adjuvant radiotherapy alone in improving LR‐RFS (hazard ratios for adjuvant CRT vs. none, 0.042; adjuvant radiotherapy alone vs. none, 0.702). Excluding positive margins, advanced DOI was the most critical factor in assessing the need for ADJ. Positive margins and advanced DOI were more appropriate criteria than EORTC 22931/RTOG 9501 for evaluating adjuvant CRT.ConclusionsAdjuvant CRT was indicated for patients with positive margins and advanced DOI to improve survival outcomes.

Funder

Chung Shan Medical University Hospital

Publisher

Wiley

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