Surgery First Found to Improve Oral Cancer Outcomes
(HealthDay News) – For patients with oral cavity squamous cell carcinoma (OCSCC), outcomes are improved with surgery first, according to a study published online Dec. 26 in JAMA Otolaryngology-Head & Neck Surgery.
Steven B. Chinn, MD, from the University of Michigan in Ann Arbor, and colleagues retrospectively evaluated 19 patients with resectable Stages III and IV OCSCC. The patients were enrolled into a Phase 2 induction selection trial in which patients with a response of ≥50% underwent concurrent chemoradiotherapy, while those with a response of <50% underwent surgical treatment and radiotherapy. These patients were matched and compared to patients treated with primary surgical extirpation during a similar time period.
The researchers found that the Kaplan-Meier estimate for overall survival at five years was 32% in the induction selection cohort and 65% in the surgical cohort. A similar estimate for disease-specific survival was 46% in the induction selection cohort and 75% in the surgical cohort at five years, and estimates for locoregional control at five years were 26% and 72%, respectively. Multivariable analysis showed that in the surgical cohort there was significantly better overall and disease-specific survival and locoregional control outcomes (P=0.03, P=0.001, and P<0.001, respectively).
"Primary surgical treatment showed significantly better survival and locoregional control compared with induction selection in this matched patient cohort," the authors write.