Clinical outcome and prognostic factors in recurrent oral squamous cell carcinoma after primary surgical treatment: a retrospective study

被引:20
作者
Zittel, Sven [1 ]
Moratin, Julius [1 ]
Horn, Dominik [1 ,2 ]
Metzger, Karl [1 ]
Ristow, Oliver [1 ]
Engel, Michael [1 ]
Mrosek, Jan [1 ]
Freier, Kolja [1 ,2 ]
Hoffmann, Jurgen [1 ]
Freudlsperger, Christian [1 ]
机构
[1] Univ Heidelberg Hosp, Dept Oral & Craniomaxillofacial Surg, Neuenheimer Feld 400, D-69120 Heidelberg, Germany
[2] Saarland Univ Hosp, Dept Oral & Craniomaxillofacial Surg, Kirrberger Str, D-66424 Homburg, Germany
关键词
Recurrent oral squamous cell carcinoma; Salvage surgery; Oral cancer; Ablative surgery; Disease-free interval; SALVAGE SURGERY; CAVITY CANCER; NECK CANCERS; HEAD; CHEMOTHERAPY; RADIOTHERAPY; SURVIVAL; UPDATE; CHOICE;
D O I
10.1007/s00784-021-04186-y
中图分类号
R78 [口腔科学];
学科分类号
1003 ;
摘要
Objectives Survival for patients with recurrent oral squamous cell carcinoma is usually poor, and the most effective treatment has not yet been clearly defined. The present study evaluates the outcome in radiotherapy-naive patients after recurrence of oral squamous cell carcinoma with respect to different treatment modalities including surgery, radiation, chemoradiation, and palliative treatment. Patients and methods In this retrospective study, we included all patients with primary oral squamous cell carcinoma who received exclusively surgical therapy between 2010 and 2020 and who suffered from locoregional recurrence in their follow-up. Patients with previous adjuvant therapy were excluded from this protocol. Clinical and pathological parameters were collected and statistically evaluated. Survival analysis was performed according to Kaplan-Meier. The primary endpoints were overall and progression-free survival in dependance of treatment strategy for recurrent tumors. Results Out of a total of 538 patients with surgically treated primary oral squamous cell carcinoma, 76 patients met the inclusion criteria. The mean follow-up was 38 +/- 32 months. Patients who received surgically based therapy had a significantly better outcome in terms of disease-free survival (DFS) and overall survival (OS) (DFS p < 0.001; OS p < 0.001). The presence of regional metastases and a short disease-free interval (DFI) between primary and recurrent cancer were significant predictors for adverse outcomes (DFI p < 0.001). Conclusion We recommend primary surgical therapy for radiotherapy-naive patients with recurrent oral squamous cell carcinoma, supplemented by risk-adapted adjuvant therapy.
引用
收藏
页码:2055 / 2064
页数:10
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