Salvage therapy in relapsed squamous cell carcinoma of the oral cavity: How and when?

被引:85
作者
Liao, Chun-Ta [1 ,2 ,3 ]
Chang, Joseph Tung-Chieh [3 ,4 ]
Wang, Hung-Ming [3 ,4 ]
Ng, Shu-Hang [3 ,4 ]
Hsueh, Chuen [3 ,4 ]
Lee, Li-Yu [3 ,4 ]
Lin, Chih-Hung [3 ,4 ]
Chen, I-How [1 ,2 ,3 ]
Huang, Shiang-Fu [1 ,2 ,3 ]
Cheng, Ann-Joy [3 ,4 ]
Yen, Tzu-Chen [3 ,5 ]
机构
[1] Chang Gung Univ, Chang Gung Mem Hosp, Dept Otorhinolaryngol, Tao Yuan, Taiwan
[2] Chang Gung Univ, Chang Gung Mem Hosp, Dept Head & Neck Surg, Tao Yuan, Taiwan
[3] Chang Gung Univ, Chang Gung Mem Hosp, Head & Neck Oncol Grp, Tao Yuan, Taiwan
[4] Chang Gung Univ, Chang Gung Mem Hosp, Tao Yuan, Taiwan
[5] Chang Gung Univ, Chang Gung Mem Hosp, Nucl Med & Mol Imaging Ctr, Tao Yuan, Taiwan
关键词
squamous cell carcinoma; oral cavity; survival; salvage therapy;
D O I
10.1002/cncr.23142
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUND. Relapse of tumors in patients with oral cavity squamous cell carcinoma (OSCC) is associated with a poor prognosis. In addition, salvage therapy may be a significant source of morbidity in patients with relapsing OSCC. The objective of the current Study was to determine prognostic factors that predict which patients may benefit from such treatment. METHODS. From 953 patients who underwent primary radical surgery between 1996 and 2005, 272 patients with early-relapsed OSCC (n = 161) or late-relapsed OSCC (n = 111) were identified. The optimium cutoff point for relapse was chosen on the basis of 5-year disease-specific survival (T)SS) and overall Survival (OS). RESULTS. The optimal cutoff value for relapse was 10 months. Late relapses were associated with a better prognosis than relapses that occurred within the first 10 months (P <.0001 for both 5-year DSS and 5-year OS). Among patients with early-relapsed OSCC, a primary tumor depth <10 mm was associated significantly and independently with a better 5-year DSS (P =.014) and OS (P =.011). Among patients with late-relapsed OSCC, neck recurrence was a significant risk factor for adverse Outcomes (P <.001 for both 5-year DSS and 5-year OS). CONCLUSIONS. A late relapse was associated with better survival than a relapse that occurred within the first 10 months. Patients with late-relapsed OSCC may benefit from salvage therapy, especially those who have a local recurrence. Among patients with early-relapsed OSCC, salvage therapy should be considered for those who have a primary tumor depth <10 mm.
引用
收藏
页码:94 / 103
页数:10
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