Survival outcomes after treatment of cancer of the oral cavity (1985–2015). (March 2019)

• Record Type: Journal Article
• Authors: Zanoni, Daniella Karassawa; Montero, Pablo H.; Migliacci, Jocelyn C.; Shah, Jatin P.; Wong, Richard J.; Ganly, Ian; Patel, Snehal G.
• Is Part Of: Oral oncology. Volume 90(2019)
• Page Start: 115
• Page End: 121
• Publication Date: 2019-03
• Subjects: Mouth neoplasms -- Mouth cancer -- Oral neoplasms -- Oral cancer -- Squamous cell carcinoma -- Epidermoid carcinoma -- Head and neck neoplasms -- Head and neck cancer -- Upper aerodigestive tract neoplasms; OSCC oral squamous cell carcinoma -- OS overall survival -- DSS disease specific survival -- CPT current procedural terminology -- ICD international classification of diseases -- WUHNCI Washington University head and neck comorbidity index -- AJCC American Joint Committee on Cancer -- ENE extranodal extension -- DOI depth of invasion -- NCDB National Cancer Database -- SEER Surveillance Epidemiology and End Results Program; Mouth -- Cancer -- Periodicals; Mouth -- Tumors -- Periodicals; Mouth Diseases -- Periodicals; Mouth Neoplasms -- Periodicals; Bouche -- Cancer -- Périodiques; Bouche -- Tumeurs -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9943105
• DOI: 10.1016/j.oraloncology.2019.02.001
• Languages: English
• ISSNs: 1368-8375

Abstract

Highlights: 2082 patients with OSCC operated at a tertiary cancer care center from 1985 to 2015 were studied. Age, comorbidity, margin, vascular and perineural invasion, T, N were independent predictors of OS. Alcohol use, margin, vascular and perineural invasion, T, and N were independent predictors of DSS. pN was the single most powerful and consistent predictor of outcome in patients with OSCC. Abstract: Objectives: To present treatment results of oral squamous cell carcinoma (OSCC) at a tertiary cancer care center from 1985 to 2015. Materials and methods: A total of 2082 patients were eligible for this study. Main outcomes measured were overall survival (OS) and disease specific survival (DSS). Prognostic variables were identified with bivariate analyses using Kaplan-Meier curves and log-rank testing for comparison. A p-value < 0.05 was considered statistically significant and significant factors were entered into multivariate analysis. Median age was 62 years (16–100), 56% were men, 66% reported a history of tobacco use and 71% of alcohol consumption. The most common subsite was tongue (51%). Seventy-three percent of patients had cT1-2 and 71% had clinically negative necks (cN0). Surgery alone was performed in 1348 patients (65%), adjuvant postoperative radiotherapy in 608 patients (29%) and postoperative chemoradiation in 126 patients (6%). Neck dissection was performed in 920 patients with cN0, and in 585 patients with a clinically involved neck. The median follow-up was 37.6 months (range 1–382). Results: The 5-year OS and DSS were 64.4% and 79.3%, respectively. Age, comorbidities, margin status, vascular invasion, perineural invasion, AJCC 8th edition pT, and pN were independent prognostic factors of OS (p < 0.05). History of alcohol consumption, margin status, vascular invasion, perineural invasion, pT, and pN were independent prognostic factors of DSS (p < 0.05). Conclusion: pN stage is the most powerful and consistent predictor of outcome in patients with OSCC treated with primary surgery and appropriate adjuvant therapy.