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The Therapeutic Benefit of Radical Resection for T4b Oral Cavity Squamous Cell Carcinoma with Partial or Complete Response After Radical Chemo-Intensity-Modulated Radiotherapy (IMRT)

  • Head and Neck Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

This study investigated the therapeutic benefit of radical resection (SRR) for clinical T4b oral cavity squamous cell carcinoma (OSCC) with partial or complete response after radical chemoradiotherapy (CRT).

Methods

At the authors’ institution, 79 patients with newly diagnosed non-metastatic T4b OSCC were treated with CRT from January 2009 to December 2014. All of them were irradiated using intensity-modulated radiotherapy (IMRT), with a radical dose (median 70 Gy; range 66–76 Gy) in the gross tumor area. Of the 65 cases achieving partial or complete response after CRT, 33 were treated further with SRR and 32 with adjuvant chemotherapy or observation. The locoregional control (LRC), overall survival (OS), and cancer-free survival (CFS) rates were compared between the two groups.

Results

The 3-year LRC, OS, and CFS rates were respectively 72.3, 75.1, and 72.6 % in the SRR group compared with 32.8, 47.7, and 44.3 % in the non-SRR group (p < 0.05). Multivariate analysis showed that SRR was the only statistically significant prognostic factor related to LRC, OS, and CFS. For those with SRR, pathologic downstaging was observed in 27 cases (81.8 %). Perioperative flap failure was observed in three cases (9.2 %) and neck wound necrosis in four cases (12.1 %).

Conclusions

For T4b OSCC, incorporating SRR in the therapy is technically safe and has survival benefit, with a significant response after CRT applied by IMRT, with a radical dose in the gross tumor area.

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Acknowledgment

This work was supported in part by Grants CMRPG8C0581-3 and CMRPG8C1141-3 from the Chang Gung Memorial Hospital, Taiwan and accepted as an oral presentation at the AHNS 9th International Conference on Head and Neck Cancer.

Conflict of interest

There are no conflicts of interest.

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Authors and Affiliations

  1. Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Fu-Min Fang MD, PhD, Shang-Yu Chou MD & Chong-Jong Wang MD

  2. Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan

    Fu-Min Fang MD, PhD, Hui-Ching Chuang MD, PhD, FACS, Tai-Lin Huang MD, Chong-Jong Wang MD, Yu-Tsai Lin MD, FACS, Tai-Jan Chiu MD, Wei-Che Lin MD, PhD, Shau-Hsuan Li MD, Yan-Ye Su MD & Chih-Yen Chien MD, FACS

  3. Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Hui-Ching Chuang MD, PhD, FACS, Yu-Tsai Lin MD, FACS, Yan-Ye Su MD & Chih-Yen Chien MD, FACS

  4. Department of Hematology and Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Tai-Lin Huang MD, Tai-Jan Chiu MD & Shau-Hsuan Li MD

  5. Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan

    Wei-Che Lin MD, PhD

Authors
  1. Fu-Min Fang MD, PhD
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  2. Hui-Ching Chuang MD, PhD, FACS
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  3. Shang-Yu Chou MD
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  4. Tai-Lin Huang MD
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  5. Chong-Jong Wang MD
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  6. Yu-Tsai Lin MD, FACS
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  7. Tai-Jan Chiu MD
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  8. Wei-Che Lin MD, PhD
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  9. Shau-Hsuan Li MD
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  10. Yan-Ye Su MD
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  11. Chih-Yen Chien MD, FACS
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Corresponding author

Correspondence to Chih-Yen Chien MD, FACS.

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Fang, FM., Chuang, HC., Chou, SY. et al. The Therapeutic Benefit of Radical Resection for T4b Oral Cavity Squamous Cell Carcinoma with Partial or Complete Response After Radical Chemo-Intensity-Modulated Radiotherapy (IMRT). Ann Surg Oncol 23 (Suppl 5), 866–873 (2016). https://doi.org/10.1245/s10434-016-5568-6

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  • DOI: https://doi.org/10.1245/s10434-016-5568-6

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