Multicenter Retrospective Study of Adjuvant Therapy for Patients with Pathologically Lymph Node-Positive Oral Squamous Cell Carcinoma: Analysis of Covariance Using Propensity Score

被引:15
|
作者
Yanamoto, Souichi [1 ]
Otsuru, Mitsunobu [2 ]
Ota, Yoshihide [2 ]
Okura, Masaya [3 ]
Aikawa, Tomonao [3 ]
Kurita, Hiroshi [4 ]
Kamata, Takahiro [4 ]
Kirita, Tadaaki [5 ]
Yamakawa, Nobuhiro [5 ]
Ueda, Michihiro [6 ]
Yamashita, Tetsuro [6 ]
Komori, Takahide [7 ]
Shigeta, Takashi [7 ]
Yokoo, Satoshi [8 ]
Ogawa, Masaru [8 ]
Umeda, Masahiro [1 ]
机构
[1] Nagasaki Univ, Grad Sch Biomed Sci, Dept Clin Oral Oncol, Unit Translat Med, Nagasaki 852, Japan
[2] Tokai Univ, Sch Med, Dept Oral & Maxillofacial Surg, Div Surg, Isehara, Kanagawa 25911, Japan
[3] Osaka Univ, Grad Sch Dent, Dept Oral & Maxillofacial Surg 1, Osaka, Japan
[4] Shinshu Univ, Sch Med, Dept Dent & Oral Surg, Matsumoto, Nagano 390, Japan
[5] Nara Med Univ, Sch Med, Dept Oral & Maxillofacial Surg, Kashihara, Nara 634, Japan
[6] Keiyukai Sapporo Hosp, Dept Oral & Maxillofacial Surg, Sapporo, Hokkaido, Japan
[7] Kobe Univ, Grad Sch Med, Dept Oral & Maxillofacial Surg, Kobe, Hyogo 657, Japan
[8] Gunma Univ, Grad Sch Med, Dept Stomatol & Maxillofacial Surg, Maebashi, Gunma 371, Japan
关键词
LOCALLY ADVANCED HEAD; HIGH-RISK; NECK-CANCER; POSTOPERATIVE CHEMORADIOTHERAPY; RADIATION-THERAPY; SURGICAL MARGIN; CHEMOTHERAPY; RADIOTHERAPY; SURVIVAL; RECURRENCE;
D O I
10.1245/s10434-015-4824-5
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background. The presence of pathologically positive lymph nodes (pN+) is a well-known prognostic factor in oral squamous cell carcinoma (OSCC). The aims of this retrospective multicenter study were to assess the prognosis of OSCC patients with pN+ disease; to compare the prognosis of patients with pN+ disease who underwent surgery plus radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) with that of patients who underwent surgery only; and to account for biases associated with treatment selection of adjuvant RT or CCRT. Methods. The records of 313 OSCC patients with pN+ disease were retrospectively reviewed. The main outcome measures were 5-year disease-specific survival (DSS) and overall survival (OS) rates. To reduce selection biases associated with retrospective data, the treatment groups were evaluated by Cox proportional hazard analysis with propensity score as a covariate. Results. The 5-year OS and DSS survival rates for the entire patient cohort were 51.8 and 59.2 %, respectively. T3-4 stage, closed (<5 mm) margin distance, >= 4 involved nodes, and extracapsular spread were significant poor prognostic factors for OS and DSS. In the propensity score analysis, postoperative RT/CCRT significantly improved OS and DSS compared to surgery only. However, OS and DSS were not significantly different between patients who received postoperative RT and CCRT. Conclusion. The addition of cytotoxic chemotherapy to RT does not provide additional survival benefit in OSCC patients with pN+ disease. Alternative strategies, such as molecular targeted therapies, are needed to further improve the survival of high-risk OSCC patients with pN+ disease.
引用
收藏
页码:S992 / S999
页数:8
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