Dataset Information

Adjuvant therapy may be omitted for oral cavity cancer with only one positive lymph node.

ABSTRACT:

Objective

Whether to administer adjuvant treatment is a matter of great debate for oral cavity cancer harboring a single positive node without extranodal extension and positive margin (defined as low/intermediate risk pN1_new in this study).

Methods

A total of 243 low/intermediate risk pN1_new patients with oral cavity cancer who received curative surgery were included. Overall survival (OS), local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), and distant metastasis-free survival (DMFS) were compared between patients receiving adjuvant treatment and observation alone.

Results

For patients receiving adjuvant therapy vs observation, the differences in outcomes were not statistically significant in terms of 5-year OS, LRFS, RRFS, and DMFS. For subgroup analysis, in low/intermediate pN1_new patients with one or more minor risk factors, adjuvant therapy was not significantly associated with OS, LRFS, RRFS, or DMFS in pN1_new patients.

Conclusion

For low/intermediate risk pN1_new patients with oral cavity cancer, adjuvant therapy might be omitted.

Level of evidence

SUBMITTER: Chen WY

PROVIDER: S-EPMC8665423 | biostudies-literature | 2021 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Adjuvant therapy may be omitted for oral cavity cancer with only one positive lymph node.

Chen Wan-Yu WY Fang Ku-Hao KH Wang Chun-Wei CW Liao Chun-Ta CT Yen Tzu-Chen TC Fang Taun-Jen TJ Lai Shih-Fan SF Liang Hsiang-Kuang HK Huang Bing-Shen BS

Laryngoscope investigative otolaryngology 20211019 6

<h4>Objective</h4>Whether to administer adjuvant treatment is a matter of great debate for oral cavity cancer harboring a single positive node without extranodal extension and positive margin (defined as low/intermediate risk pN1<sub>new</sub> in this study).<h4>Methods</h4>A total of 243 low/intermediate risk pN1<sub>new</sub> patients with oral cavity cancer who received curative surgery were included. Overall survival (OS), local recurrence-free survival (LRFS), regional recurrence-free survi ...[more]

PMID: 34938872

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Project description:BackgroundSurgery and postoperative adjuvant therapy comprise the standard treatment for locally advanced resectable oral squamous cell carcinoma (LAROSCC), while preoperative neoadjuvant therapy is being explored without sufficient confirmation of improved survival. De-escalation regimens after neoadjuvant therapy, such as those omitting adjuvant radiotherapy, may provide comparable or better outcomes, suggesting rigorous assessment of adjuvant therapy outcomes is needed in LAROSCC patients. The authors thus performed this retrospective study in LAROSCC patients who received neoadjuvant therapy and surgery, to compare the outcomes for overall survival (OS) and locoregional recurrence-free survival (LRFS) between the adjuvant radiotherapy (radio) and nonradiotherapy (nonradio) cohorts.Materials and methodsPatients diagnosed with LAROSCC who received neoadjuvant therapy and surgery were enrolled and divided into radio and nonradio cohorts to determine whether adjuvant radiotherapy could be omitted after neoadjuvant therapy and surgery.ResultsFrom 2008 to 2021, 192 patients were enrolled. No significant differences were found in OS or LRFS between the radio and nonradio patient cohorts. The 10-year estimated OS rates were 58.9 versus 44.1% in radio versus nonradio cohorts, while 10-year estimated LRFS rates were 55.4 versus 48.2%, respectively. For clinical stage III patients, 10-year OS rates were 62.3 versus 62.6% (radio vs. nonradio), and estimated 10-year LRFS rates were 56.5 versus 60.7% (radio vs. nonradio). Multivariate Cox regression modeling of postoperative variables showed pathologic response of primary tumor and pathologic regional lymph nodes staging were associated with survival, while the adjuvant radiotherapy exposure was not included in the model due to nonsignificance.ConclusionThese findings support further prospective evaluation of adjuvant radiotherapy omission, and suggest that de-escalation trials are warranted for LAROSCC surgery patients who received neoadjuvant therapy.

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Dataset Information

Adjuvant therapy may be omitted for oral cavity cancer with only one positive lymph node.

Objective

Methods

Results

Conclusion

Level of evidence

Publications

Adjuvant therapy may be omitted for oral cavity cancer with only one positive lymph node.

Similar Datasets

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