The role of adjuvant radiotherapy in locally advanced T4 mandible squamous cell carcinoma in the N0 patient: a single centre experience. Issue 10 (October 2022)

• Record Type: Journal Article
• Authors: Lee, C.W.; Jenkins, G.W.; Lee-Warder, L.; Kennedy, M.; Iqbal, M.S.; Adams, J.
• Is Part Of: International journal of oral & maxillofacial surgery. Volume 51:Issue 10(2022)
• Page Start: 1251
• Page End: 1256
• Publication Date: 2022-10
• Subjects: oral cancer -- squamous cell carcinoma -- risk -- adjuvant radiotherapy -- surgical oncology; 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.2022.01.003
• Languages: English
• ISSNs: 0901-5027

Abstract

Abstract: In locally advanced oral squamous cell carcinoma (OSCC), namely that showing invasion of the mandible, demonstrating no high-risk (e.g. extranodal extension, positive margin) or intermediate-risk histopathological features (e.g. perineural invasion, lymphovascular invasion), the additional benefit of postoperative radiotherapy (PORT) currently remains uncertain. A retrospective review covering the period between January 1, 2010 and December 31, 2019 was conducted to identify patients from a single UK centre with locally advanced invasive mandibular OSCC defined as pT4a, with no nodal or distant metastasis (N0 M0). The primary outcome was to determine the disease-free survival and overall survival rates in the surgery + PORT group, in comparison to the surgery only group. Twenty-eight eligible patients were identified, with 13 patients in the surgery + PORT group and 15 patients in the surgery only group. A single patient in the surgery + PORT group developed disease recurrence and subsequently died (1/13) (median follow-up 5.24 years, range 2.13–10.71 years). No patient in the surgery only group developed disease recurrence or died (0/15) (median follow-up 5.13 years, range 1.37–10.93 years). It may be reasonable to consider omitting PORT in pT4a pN0 M0 OSCC of the mandible in patients who demonstrate no high- or intermediate-risk histopathological features, following multidisciplinary team discussion.