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Clinical Outcomes of Taiwanese Patients with cT4 Oral Cavity Squamous Cell Carcinoma: Toward the Identification of the Optimal Initial Treatment Approach for cT4b Patients
- Source :
- Annals of surgical oncology. 24(3)
- Publication Year :
- 2016
-
Abstract
- The National Comprehensive Cancer Network guidelines recommend that patients with oral cavity squamous cell carcinoma (OSCC) and cT4b disease should be either included in clinical trials or treated with a nonsurgical approach. However, surgery may be feasible in selected patients with adequate safety margins. Using the nationwide Taiwanese Cancer Registry Database, we examined the prognosis of cT4b OSCC patients in relation to their treatment approach.Of the 18,910 patients with previously untreated first primary OSCC identified between 2004 and 2010, 492 (2.6 %) had cT4b tumors. Of them, 327 (66 %) received initial treatment with surgery, whereas 165 (34 %) were initially treated with a nonsurgical approach. Of the latter group, 78 patients subsequently underwent surgery. A 5-year disease-specific survival (DSS) ≥45 % was considered as a favorable outcome.Better 5-year DSS and overall survival (OS) rates were observed in cT4b patients initially treated with surgery (vs. nonsurgery; DSS, 51 vs. 38 %; OS, 43 vs. 27 %, respectively, p 0.001). Of the participants initially treated with surgery, patients with cN0-2 disease had better 5-year survival rates (DSS: cN0, 59 %; cN1, 53 %; cN2, 46 %; OS: cN0, 49 %; cN1, 50 %; cN2, 37 %) than those with cN3 disease (DSS: 0 %; OS: 0 %). Among cT4b patients who initially received a nonsurgical treatment, subjects who subsequently underwent surgery showed better outcomes.Primary surgery is performed in approximately two-thirds of cT4b OSCC patients, with cN0-2 cases showing a good prognosis. Patients who initially received a nonsurgical approach can subsequently be treated with surgery and achieve favorable outcomes.
- Subjects :
- 0301 basic medicine
Oncology
Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Taiwan
Antineoplastic Agents
03 medical and health sciences
0302 clinical medicine
Surgical oncology
Internal medicine
medicine
Carcinoma
Humans
Oral Cavity Squamous Cell Carcinoma
Survival rate
Aged
Neoplasm Staging
Radiotherapy
business.industry
Cancer
Middle Aged
medicine.disease
Prognosis
Combined Modality Therapy
Surgery
Cancer registry
Clinical trial
Radiation therapy
Survival Rate
stomatognathic diseases
030104 developmental biology
030220 oncology & carcinogenesis
Lymphatic Metastasis
Carcinoma, Squamous Cell
Female
Mouth Neoplasms
business
Subjects
Details
- ISSN :
- 15344681
- Volume :
- 24
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Annals of surgical oncology
- Accession number :
- edsair.doi.dedup.....cdb2f189135c9b03d5d9c988ced40dca