Surgical or Non-surgical Treatment for Advanced Oral Cavity Cancer
Surgery remains the standard of care for oral cavity squamous cell carcinoma despite advances in organ preservation for other head and neck cancer subsites. This chapter seeks to elucidate the efficacy between surgical and non-surgical options for the treatment of advanced stage oral cavity squamous cell carcinoma. The PubMed and MEDLINE databases were searched for relevant articles pertaining to this topic. The results were limited to English only and the oldest article included was from 2009. One randomized controlled trial and two large database retrospective reviews were included. All three of these articles favored surgical resection and adjuvant therapy over definitive chemoradiotherapy based on improved overall survival and/or disease-specific survival with surgery. Five retrospective cohort studies were included with mixed results. Two of these studies found both interventions were equivalent in regards to overall survival, while one retrospective cohort study showed equivalent overall survival but improved locoregional control with surgery. Two retrospective cohort studies favor surgery based on higher progression-free survival and overall survival results. Overall the data show that patients with advanced stage oral cavity squamous cell carcinoma should be treated with surgical resection and appropriate adjuvant therapy.
KeywordsSquamous cell carcinoma Advanced oral cavity cancer Surgery Chemoradiation Survival
- 2.Nobel AR, Greskovich JF, Han J, Reddy CA, Nwizu TI, Khan MF, et al. Risk factors associated with disease recurrence in patients with stage III/IV squamous cell carcinoma of the oral cavity treated with surgery and postoperative radiotherapy. Anticancer Res. 2016;36(2):785–92.Google Scholar
- 4.Furness S, Glenny A-M, Worthington HV, et al. Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy. Cochrane Database Syst Rev. 2011. https://doi.org/10.1002/14651858.cd006386.pub3.
- 5.Owosho AA, Tsai CJ, Lee RS, Freymiller H, Kadempour A, Varthis S, et al. The prevalence and risk factors associated with osteoradionecrosis of the jaw in oral and oropharyngeal cancer patients treated with intensity-modulated radiation therapy (IMRT): The Memorial Sloan Kettering Cancer Center experience. Oral Oncol. 2017;64:44–51.CrossRefGoogle Scholar
- 6.Iyer NG, Tan DS, Tan VK, et al. Randomized trial comparing surgery and adjuvant radiotherapy versus concurrent chemoradiotherapy in patients with advanced, nonmetastatic squamous cell carcinoma of the head and neck: 10-year update and subset analysis. Cancer. 2015;121(10):1599–607. https://doi.org/10.1002/cncr.29251.CrossRefPubMedGoogle Scholar
- 7.Spiotto MT, Jefferson G, Wenig B, Markiewicz M, Weichselbaum RR, Koshy M. Differences in survival with surgery and postoperative radiotherapy compared with definitive chemoradiotherapy for oral cavity cancer. JAMA Otolaryngol Head Neck Surg. 2017;143(7):691. https://doi.org/10.1001/jamaoto.2017.0012.CrossRefPubMedPubMedCentralGoogle Scholar
- 11.Sher DJ, Thotakura V, Balboni TA, et al. Treatment of oral cavity squamous cell carcinoma with adjuvant or definitive intensity-modulated radiation therapy. Int J Radiat Oncol Biol Phys. 2011;81(4). https://doi.org/10.1016/j.ijrobp.2011.02.023.
- 12.Elbers JB, Al-Mamgani A, Paping D, et al. Definitive (chemo)radiotherapy is a curative alternative for standard of care in advanced stage squamous cell carcinoma of the oral cavity. Oral Oncol. 2017;75:163–8. https://doi.org/10.1016/j.oraloncology.2017.11.006.CrossRefPubMedGoogle Scholar
- 13.Stenson KM, Kunnavakkam R, Cohen EEW, et al. Chemoradiation for patients with advanced oral cavity cancer. Laryngoscope 2009. https://doi.org/10.1002/lary.20716.
- 15.Foster CC, Melotek JM, Brisson RJ, et al. Definitive chemoradiation for locally-advanced oral cavity cancer: a 20-year experience. Oral Oncol. 2018;80:16–22. https://doi.org/10.1016/j.oraloncology.2018.03.008.CrossRefPubMedGoogle Scholar
- 16.Crombie AK, Farah C, Tripcony L, Dickie G, Batstone MD. Primary chemoradiotherapy for oral cavity squamous cell carcinoma. Oral Oncol. 2012;48(10):1014–8. https://doi.org/10.1016/j.oraloncology.2012.03.027.CrossRefPubMedGoogle Scholar
- 17.Scher ED, Romesser PB, Chen C, et al. Definitive chemoradiation for primary oral cavity carcinoma: a single institution experience. Oral Oncol. 2015;51(7):709–15. https://doi.org/10.1016/j.oraloncology.2015.04.007.CrossRefPubMedPubMedCentralGoogle Scholar