Cancer · 2018
The role of adjuvant treatment in early-stage oral cavity squamous cell carcinoma: An international collaborative study.
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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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, International Consortium for Outcome Research in Head and Neck Cancer
Аннотация
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.
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.
Предметные рубрики MeSH
AdultAgedChemoradiotherapy, AdjuvantDisease-Free SurvivalFemaleHumansInternational CooperationKaplan-Meier EstimateMaleMargins of ExcisionMiddle AgedMouthMouth NeoplasmsNeoplasm InvasivenessNeoplasm Recurrence, LocalNeoplasm StagingPrognosisRadiotherapy, AdjuvantRetreatmentRetrospective StudiesSquamous Cell Carcinoma of Head and Neck