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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2016

01-12-2016 | Head and Neck Oncology

The Therapeutic Benefit of Radical Resection for T4b Oral Cavity Squamous Cell Carcinoma with Partial or Complete Response After Radical Chemo-Intensity-Modulated Radiotherapy (IMRT)

Authors: Fu-Min Fang, MD, PhD, Hui-Ching Chuang, MD, PhD, FACS, Shang-Yu Chou, MD, Tai-Lin Huang, MD, Chong-Jong Wang, MD, Yu-Tsai Lin, MD, FACS, Tai-Jan Chiu, MD, Wei-Che Lin, MD, PhD, Shau-Hsuan Li, MD, Yan-Ye Su, MD, Chih-Yen Chien, MD, FACS

Published in: Annals of Surgical Oncology | Special Issue 5/2016

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Abstract

Background

This study investigated the therapeutic benefit of radical resection (SRR) for clinical T4b oral cavity squamous cell carcinoma (OSCC) with partial or complete response after radical chemoradiotherapy (CRT).

Methods

At the authors’ institution, 79 patients with newly diagnosed non-metastatic T4b OSCC were treated with CRT from January 2009 to December 2014. All of them were irradiated using intensity-modulated radiotherapy (IMRT), with a radical dose (median 70 Gy; range 66–76 Gy) in the gross tumor area. Of the 65 cases achieving partial or complete response after CRT, 33 were treated further with SRR and 32 with adjuvant chemotherapy or observation. The locoregional control (LRC), overall survival (OS), and cancer-free survival (CFS) rates were compared between the two groups.

Results

The 3-year LRC, OS, and CFS rates were respectively 72.3, 75.1, and 72.6 % in the SRR group compared with 32.8, 47.7, and 44.3 % in the non-SRR group (p < 0.05). Multivariate analysis showed that SRR was the only statistically significant prognostic factor related to LRC, OS, and CFS. For those with SRR, pathologic downstaging was observed in 27 cases (81.8 %). Perioperative flap failure was observed in three cases (9.2 %) and neck wound necrosis in four cases (12.1 %).

Conclusions

For T4b OSCC, incorporating SRR in the therapy is technically safe and has survival benefit, with a significant response after CRT applied by IMRT, with a radical dose in the gross tumor area.
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Metadata
Title
The Therapeutic Benefit of Radical Resection for T4b Oral Cavity Squamous Cell Carcinoma with Partial or Complete Response After Radical Chemo-Intensity-Modulated Radiotherapy (IMRT)
Authors
Fu-Min Fang, MD, PhD
Hui-Ching Chuang, MD, PhD, FACS
Shang-Yu Chou, MD
Tai-Lin Huang, MD
Chong-Jong Wang, MD
Yu-Tsai Lin, MD, FACS
Tai-Jan Chiu, MD
Wei-Che Lin, MD, PhD
Shau-Hsuan Li, MD
Yan-Ye Su, MD
Chih-Yen Chien, MD, FACS
Publication date
01-12-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue Special Issue 5/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5568-6

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