Survival of patients with pathologic T0N+ oral and oropharyngeal cancer after neoadjuvant therapy and surgery: the minority report

Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 Mar;115(3):293-8. doi: 10.1016/j.oooo.2012.03.033. Epub 2012 Aug 30.

Abstract

Objectives: Treatment outcome of patients with oral and oropharyngeal squamous cell carcinoma (OOSCC) achieving complete pathologic response at the primary site (ypT0) but incomplete response in loco-regional lymph nodes after preoperative chemoradiation (ypN+) is poorly described in the literature. This study's objective was to assess the survival of patients with OOSCC with ypT0N+ disease.

Study design: 176 patients with primary locally advanced OOSCC undergoing preoperative chemoradiotherapy were stratified according to the pathologic TNM classification into 6 groups: ypT0N0M0 (46%), ypT0N+M0 (10%), ypTNM I (24%), ypTNM II (4%), ypTNM III (6%), and ypTNM IV (10%).

Results: Three-year overall survival (OS) and recurrence-free survival (RFS) rates for the ypT0N+M0 group were both 61.8% and were similar to those of the ypTNM I group (OS 62.4%; RFS rate of 59.2%).

Conclusions: Survival analyses showed that patients with OOSCC with ypT0N+ disease have a similar prognosis to those with pathologic TNM stage I.

MeSH terms

  • Adult
  • Aged
  • Antibiotics, Antineoplastic / administration & dosage
  • Antimetabolites, Antineoplastic / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Carcinoma, Squamous Cell / surgery
  • Carcinoma, Squamous Cell / therapy*
  • Chemoradiotherapy, Adjuvant
  • Cohort Studies
  • Disease-Free Survival
  • Female
  • Fluorouracil / administration & dosage
  • Follow-Up Studies
  • Humans
  • Lymph Nodes / pathology
  • Male
  • Middle Aged
  • Mitomycin / administration & dosage
  • Mouth Neoplasms / surgery
  • Mouth Neoplasms / therapy*
  • Neoadjuvant Therapy*
  • Neoplasm Grading
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Oropharyngeal Neoplasms / surgery
  • Oropharyngeal Neoplasms / therapy*
  • Prognosis
  • Remission Induction
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome
  • Young Adult

Substances

  • Antibiotics, Antineoplastic
  • Antimetabolites, Antineoplastic
  • Mitomycin
  • Fluorouracil