Journal article
Adjuvant radiotherapy mitigates impact of perineural invasion on oncologic outcomes in early-stage oral cavity squamous cell carcinoma. A multi-institutional analysis of 557 patients
Oral oncology, Vol.142, pp.106420-106420
07/2023
DOI: 10.1016/j.oraloncology.2023.106420
PMCID: PMC10575471
PMID: 37182430
Abstract
Perineural invasion is associated with worse disease control in oral squamous cell carcinoma. Early-stage oral cancers with perineural invasion have worse disease-free survival. Radiation mitigates hazard for disease-free survival in perineural invasion positive cancers.
Understand the prognostic impact of perineural invasion (PNI) in early-stage oral cavity squamous cell carcinoma (OCSCC). Assess the influence of adjuvant radiotherapy on outcomes of patients with PNI-positive early-stage OCSCC.
Retrospective seven-institution cohort study including patients with pathologic T1-2 N0-1 OCSCC who underwent primary surgery with negative margins. Outcomes included disease-free survival (DFS) and locoregional control (LRC). Cox proportional hazards models were used to evaluate oncologic outcomes. Interaction terms were introduced to assess relationships between PNI and adjuvant radiotherapy.
Among 557 patients (mean (SD) age 61.0 (13.9), 47.2% female, 66.6% pathologic T1, 93.5% pathologic N0), 93 had PNI-positive tumors, among which 87.1% underwent neck dissection and 39.6% received radiotherapy. On multivariable analysis, PNI was associated with lower DFS and LRC. Adjuvant radiotherapy was not associated with improved outcomes on multivariable analysis of the entire cohort. However, among patients with PNI-positive tumors, adjuvant radiotherapy significantly decreased hazard for DFS.
Among patients with low-risk, early-stage OCSCC, PNI was associated with worse DFS and LRC. In patients with PNI-positive tumors, adjuvant radiotherapy lowered hazard for DFS on multivariable analysis. These data support using adjuvant radiotherapy for patients with early-stage OCSCC with PNI.
Details
- Title: Subtitle
- Adjuvant radiotherapy mitigates impact of perineural invasion on oncologic outcomes in early-stage oral cavity squamous cell carcinoma. A multi-institutional analysis of 557 patients
- Creators
- Andrew J. Holcomb - Department of Head & Neck Surgical Oncology, Estabrook Cancer Center, Nebraska Methodist Hospital, Omaha, NE, United StatesNathan Farrokhian - University of KansasClaire Tolan - Department of Head & Neck Surgical Oncology, Estabrook Cancer Center, Nebraska Methodist Hospital, Omaha, NE, United StatesErin Whiteford - Department of Head & Neck Surgical Oncology, Estabrook Cancer Center, Nebraska Methodist Hospital, Omaha, NE, United StatesMark Villwock - University of KansasKiran Kakarala - University of KansasYelizaveta Shnayder - University of KansasKevin Sykes - University of KansasChristopher Lominska - University of KansasGregory Gan - University of KansasMarisa R. Buchakjian - University of IowaBrette Harding - University of MissouriLaura Dooley - University of MissouriJustin Shinn - Vanderbilt UniversityC. Burton Wood - Vanderbilt UniversitySarah Rohde - Vanderbilt UniversitySobia Khaja - University of MinnesotaNicholas B. Abt - Harvard Medical SchoolMark Varvares - Harvard Medical SchoolAndrés M. Bur - University of Kansas
- Resource Type
- Journal article
- Publication Details
- Oral oncology, Vol.142, pp.106420-106420
- DOI
- 10.1016/j.oraloncology.2023.106420
- PMID
- 37182430
- PMCID
- PMC10575471
- NLM abbreviation
- Oral Oncol
- ISSN
- 1368-8375
- eISSN
- 1879-0593
- Publisher
- Elsevier Ltd
- Language
- English
- Date published
- 07/2023
- Academic Unit
- Otolaryngology
- Record Identifier
- 9984410788002771
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