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Annals of Surgical Oncology

, Volume 18, Issue 9, pp 2569–2578 | Cite as

Identification of a High-Risk Subgroup of Patients with Resected pT3 Oral Cavity Cancer in Need of Postoperative Adjuvant Therapy

  • Chun-Ta Liao
  • Chien-Yu Lin
  • Kang-Hsing Fan
  • Shiang-Fu Huang
  • I-How Chen
  • Chung-Jan Kang
  • Hung-Ming Wang
  • Shu-Hang Ng
  • Chuen Hsueh
  • Li-Yu Lee
  • Chih-Hung Lin
  • Tzu-Chen Yen
Head and Neck Oncology

Abstract

Background

The NCCN 2010 guidelines recommend the use of postoperative adjuvant radiotherapy (RT) for patients with pT3 oral cavity squamous cell carcinoma (OSCC). We sought to determine whether postoperative adjuvant RT improves outcomes in pT3N0 OSCC patients.

Methods

A total of 119 consecutive patients with pT3N0 disease were involved. A total of 42 patients received postoperative adjuvant RT, while the remaining 77 did not. The 5-year rates of control, distant metastasis, and survival were the main outcome measures.

Results

We found no differences in the risk profile of patients with and without postoperative adjuvant RT, the only exceptions being a higher frequency of tumor depth ≥10 mm (78.6% vs. 48.0%, P = .001) and close margins ≤4 mm (11.9 % vs. 2.7%, P = .043) in those treated by adjuvant RT. Tumor depth ≥10 mm was the only independent prognostic factor for 5-year local control, disease-free survival, and disease-specific survival in multivariable analysis. Tumor depth ≥13 mm was the only independent prognostic factor for the 5-year rate of distant metastases (16% [7 of 50] vs. 2% [1 of 67]). After stratification for tumor depth and adjuvant RT, patients with pT3N0 disease who received adjuvant RT did not show a survival advantage.

Conclusions

Tumor depth ≥10 mm was the only prognostic factor identified in patients with pT3N0 disease. Adjuvant RT did not improve outcomes in pT3N0 patients, regardless of tumor depth. Patients with pT3N0 and tumor depth ≥13 mm (43% of pT3N0) were at the highest risk for distant metastases.

Keywords

Neck Dissection Perineural Invasion Tumor Depth Verrucous Carcinoma Close Margin 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

This study was supported by grants CMRPG370061 and CMRPG 370062 from the Chang Gung Memorial Hospital.

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Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Chun-Ta Liao
    • 1
    • 2
  • Chien-Yu Lin
    • 2
    • 3
  • Kang-Hsing Fan
    • 2
    • 3
  • Shiang-Fu Huang
    • 1
    • 2
  • I-How Chen
    • 1
    • 2
  • Chung-Jan Kang
    • 1
    • 2
  • Hung-Ming Wang
    • 2
    • 4
  • Shu-Hang Ng
    • 2
    • 5
  • Chuen Hsueh
    • 2
    • 6
  • Li-Yu Lee
    • 2
    • 6
  • Chih-Hung Lin
    • 2
    • 7
  • Tzu-Chen Yen
    • 2
    • 8
  1. 1.Department of Otorhinolaryngology, Head and Neck SurgeryChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan, ROC
  2. 2.Department of Head and Neck Oncology GroupChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan, ROC
  3. 3.Department of Radiation OncologyChang Gung Memorial Hospital and Graduate Institute of Clinical Medical Sciences of Chang Gung UniversityTaoyuanTaiwan, ROC
  4. 4.Department of Hema-OncologyChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan, ROC
  5. 5.Department of Diagnostic RadiologyChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan, ROC
  6. 6.Department of PathologyChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan, ROC
  7. 7.Department of Plastic and Reconstructive SurgeryChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan, ROC
  8. 8.Nuclear Medicine and Molecular Imaging CenterChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan, ROC

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