Journal article
Depth of invasion alone as a prognostic factor in low‐risk early‐stage oral cavity carcinoma
The Laryngoscope, Vol.129(9), pp.2082-2086
09/2019
DOI: 10.1002/lary.27753
PMID: 30604435
Abstract
Objectives
To evaluate the significance of increasing depth of invasion (DOI) as the sole risk factor for recurrence in patients with low‐risk early‐stage oral cavity squamous cell carcinoma (OCSCC).
Methods
We retrospectively reviewed 560 patients with OCSCC treated at our institution between 2003 and 2013. Patients were included if they had low‐risk early‐stage OCSCC treated with surgical resection ± neck dissection and no adjuvant therapy. Low risk was defined as absence of positive or close margins, lymphovascular invasion, perineural invasion, and positive lymph nodes. Patients with tumor (T)3‐T4 disease were excluded. Pathology specimens were independently re‐reviewed by two board‐certified pathologists to confirm proper measurement of DOI. Kaplan‐Meier and Cox proportional hazards regression analyses were performed to identify factors predictive for recurrence as well as progression‐free survival (PFS) and overall survival (OS).
Results
A total of 126 patients with low‐risk early‐stage T1‐2N0 OCSCC were included. Median follow‐up time was 42.5 months and median DOI was 4 mm. There was no significant difference in incidence of local (P = 0.95), regional (P = 0.81), or distant recurrence (P = 0.96) among patients with DOI < 4 mm versus ≥4 mm. On multivariable analysis, DOI was significant for both PFS (P = 0.03) and OS (P = 0.002).
Conclusion
In this study, we show that in the absence of other high‐risk pathologic features, DOI ≥ 4 mm does not portend for increased incidence of local, regional, or distant relapse in patients treated with surgery alone; however, increasing DOI is a marker for worse PFS and OS in patients with low‐risk, early‐stage OCSCC.
Level of Evidence
4
Laryngoscope, 129:2082–2086, 2019
Details
- Title: Subtitle
- Depth of invasion alone as a prognostic factor in low‐risk early‐stage oral cavity carcinoma
- Creators
- Margaret M. Kozak - Department of Radiation Oncology, Stanford Cancer Institute, Stanford School of Medicine, Stanford, California.Jennifer Shah - Department of Radiation Oncology, Stanford Cancer Institute, Stanford School of Medicine, Stanford, California.Michelle Chen - Department of Otolaryngology Head and Neck Surgery Stanford School of Medicine Stanford CaliforniaKurt Schaberg - Stanford MedicineRie von Eyben - Department of Radiation Oncology, Stanford Cancer Institute, Stanford School of Medicine, Stanford, California.Jie Jane Chen - Department of Radiation Oncology, Stanford Cancer Institute, Stanford School of Medicine, Stanford, California.Timothy Bui - Department of Radiation Oncology, Stanford Cancer Institute, Stanford School of Medicine, Stanford, California.Christina Kong - Stanford MedicineMichael Kaplan - Department of Otolaryngology Head and Neck Surgery Stanford School of Medicine Stanford CaliforniaVasu Divi - Department of Otolaryngology Head and Neck Surgery Stanford School of Medicine Stanford CaliforniaWendy Hara - Department of Radiation Oncology, Stanford Cancer Institute, Stanford School of Medicine, Stanford, California.
- Resource Type
- Journal article
- Publication Details
- The Laryngoscope, Vol.129(9), pp.2082-2086
- DOI
- 10.1002/lary.27753
- PMID
- 30604435
- ISSN
- 0023-852X
- eISSN
- 1531-4995
- Number of pages
- 5
- Language
- English
- Date published
- 09/2019
- Academic Unit
- Radiation Oncology
- Record Identifier
- 9984312974102771
Metrics
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