Impact of postoperative radiotherapy on survival and loco-regional control in node-negative oral cavity tumours classified as T3 using the AJCC Cancer Staging Manual eighth edition. Issue 2 (February 2019)

• Record Type: Journal Article
• Authors: Subramaniam, N.; Balasubramanian, D.; Murthy, S.; Rathod, P.; Vidhyadharan, S.; Thankappan, K.; Iyer, S.
• Is Part Of: International journal of oral & maxillofacial surgery. Volume 48:Issue 2(2019:Feb.)
• Page Start: 152
• Page End: 156
• Publication Date: 2019-02
• Subjects: oral cancer -- AJCC 8th edition -- radiotherapy; Mouth -- Surgery -- Periodicals; Maxilla -- Surgery -- Periodicals; Dentistry -- Periodicals; Dentistry, Operative; Oral Surgical Procedures; Surgery, Oral; Dentistry; Maxilla -- Surgery; Mouth -- Surgery; Electronic journals; Periodicals; 617.52059
• DOI: 10.1016/j.ijom.2018.07.009
• Languages: English
• ISSNs: 0901-5027

Abstract

Abstract: According to the eighth edition of the AJCC Cancer Staging Manual (AJCC8), a depth of invasion (DOI) >10 mm is classified as pT3, representing a locally advanced tumour requiring postoperative radiotherapy (PORT). When node-negative, however, evidence regarding whether PORT improves loco-regional control or survival is unclear. To clarify this, two cohorts of patients were studied: (1) patients classified as pT3N0 by the seventh edition of the AJCC manual (AJCC7), with DOI >10 mm and a tumour diameter >4 cm (17 patients who received PORT), and (2) patients classified as pT1N0 and pT2N0 by AJCC7, with DOI >10 mm and a tumour diameter <4 cm (55 patients who did not receive PORT). Loco-regional control and survival were analysed. PORT was found not to impact overall survival or disease-free survival. It was also found not to impact local, regional, or distant recurrence. Although the two subsets of patients considered here (DOI >10 mm with tumour diameter below or above 4 cm) were previously distinct, they are both considered pT3 in AJCC8. Data from this study indicate that the routine administration of PORT to patients with a DOI >10 mm may not be warranted in the absence of other risk features such as nodal disease or close margins.