Postoperative radiotherapy for primary early oral tongue cancer with pathologic N1 neck

Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
Head & Neck (Impact Factor: 2.64). 01/2009; 32(5):555 - 561. DOI: 10.1002/hed.21217
Source: PubMed


The benefit of postoperative radiotherapy (PORT) for early squamous cell carcinoma of the tongue (SCCOT) with pathologic N1 disease remains unclear.Methods
The medical records of all patients with pathologic T1-2/N0-1 SCCOT who underwent wide excision of the primary tumor and neck dissection between 1980 and 2002 were reviewed.ResultsThere were 59 patients analyzed, including 28 patients with and 31 patients without PORT. The 5-year disease-free survival rates were 81.2% and 53% for the patients with and without PORT, respectively (p = .03). The overall 5-year survival rates were 77% and 70.5% for the patients with and without PORT, respectively (p = .36). Multivariate analyses showed that PORT had the only protective effect (p = .01) and extracapsular spread (ECS) was the only significantly adverse factor for locoregional recurrence (p = .03).Conclusions
Approximately one-third of the patients who received only surgery had locoregional recurrence. PORT significantly improved the disease-free survival. © 2009 Wiley Periodicals, Inc. Head Neck, 2010

Download full-text


Available from: Lai-Lei Ting
  • [Show abstract] [Hide abstract]
    ABSTRACT: This review discusses the role of adjuvant treatment after curative surgery for patients with head and neck squamous cell carcinoma (HNSCC). In general, patients with unfavourable prognostic factors have a high-risk of loco-regional recurrence and subsequent worse survival after surgery alone and are therefore considered proper candidates for adjuvant treatment by either postoperative radiotherapy alone or postoperative chemoradiation. Selection of the most optimal adjuvant treatment strategy should be based on the most important prognostic factors. In this review, the different treatment strategies will be discussed in general. More specifically, we will discuss the role of the interval between surgery and radiotherapy, the overall treatment time of radiation, the selection of target volumes for radiation and the value of adding concomitant chemotherapy to postoperative radiation.
    No preview · Article · Aug 2010 · Oral Oncology
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The impact of submandibular gland (SMG) preservation during neck dissection on the survival of patients with early-stage oral squamous-cell carcinoma (OSCC) remains undocumented. The medical records of all patients with early-stage OSCC (stage I and II) who underwent wide excision of the primary tumor and simultaneous neck dissection between 1999 and 2006 at our facility were retrospectively reviewed. We analyzed 408 patients, including 33 patients with and 375 patients without SMG preservation. The 5-year disease-free and overall survival rates were 78.8% and 90.9% for the patients with SMG preservation and 75.4% and 90.4% for the patients without SMG preservation, and these differences were not statistically significant (P = 0.79, P = 0.99, respectively). Similar survival rates between patients with and without SMG preservation were observed in those with oral tongue squamous-cell carcinoma (SCC) and with buccal SCC. Patients with T2 OSCC with SMG preservation had significantly lower 5-year disease-free survival rate than those without SMG preservation (P = 0.02), but overall survival rates were similar between these two groups. Preservation of the SMG during neck dissection may be oncologically safe in patients with T1 OSCC, but the feasibility of SMG preservation seems less clear for T2 OSCC.
    Full-text · Article · Feb 2011 · Annals of Surgical Oncology
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The positive effect of radiation therapy for patients with advanced oropharyngeal squamous cell carcinoma (OSCC) has been substantially verified. The present work investigated whether a meta-analysis of current data is able to evaluate the effectiveness of postoperative radiotherapy (PORT) in patients with small OSCC (pT1, pT2) and a single ipsilateral lymph node metastasis (pN1). The meta-analysis comprises randomized and non-randomized studies. High-risk tumors were excluded and defined by size ≥ pT3/pT4, lymph node involvement ≥ pN2, or presence of additional histological risk factors, e.g., involved positive resection margins, extra nodal spread of the disease, or lymphangiosis carcinomatosa. The primary outcome analyzed mortality between the different treatment arms. Only one prospective randomized clinical trial and six retrospective observational studies were adequate for evaluation. Descriptive analysis revealed a marginally higher mortality in the irradiation group (44% vs. 34%). In contrast, a forest plot presentation of two of seven studies with and without events in the control and therapy arms presented an advantage for the irradiation group with the limitation of large heterogeneity and a lack of statistical significance. Present data are poor and exhibit limited internal and external validity; thus, direct comparison was not possible with the eligible studies. Therefore, a meta-analysis of present data may not serve as the basis for a general treatment recommendation but underlines the need of prospective, randomized, controlled clinical trials.
    Full-text · Article · Jun 2011 · Strahlentherapie und Onkologie
Show more