Depth of invasion alone as an indication for postoperative radiotherapy in small oral squamous cell carcinomas: an international collaborative study

Ardalan Ebrahimi; Ziv Gil; Moran Amit; Tzu Chen Yen; Chun-ta Liao; Pankaj Chaturvedi; Jai Prakash Agarwal; Luiz P. Kowalski; Hugo F. Köhler; Matthias Kreppel; Claudio R. Cernea; Jason Brandao; Gideon Bachar; Andrea Bolzoni Villaret; Dan M. Fliss; Eran Fridman; Kevin Thomas Robbins; Jatin P. Shah; Snehal G. Patel; Jonathan R. Clark; The International Consortium for Outcome Research (ICOR) in Head and Neck Cancer

doi:10.1002/hed.25633

Depth of invasion alone as an indication for postoperative radiotherapy in small oral squamous cell carcinomas: an international collaborative study

Ardalan Ebrahimi^*, Ziv Gil, Moran Amit, Tzu Chen Yen, Chun-ta Liao, Pankaj Chaturvedi, Jai Prakash Agarwal, Luiz P. Kowalski, Hugo F. Köhler, Matthias Kreppel, Claudio R. Cernea, Jason Brandao, Gideon Bachar, Andrea Bolzoni Villaret, Dan M. Fliss, Eran Fridman, Kevin Thomas Robbins, Jatin P. Shah, Snehal G. Patel, Jonathan R. ClarkThe International Consortium for Outcome Research (ICOR) in Head and Neck Cancer

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

26 Citations (Scopus)

Abstract

Background: We aimed to investigate whether depth of invasion (DOI) should be an independent indication for postoperative radiotherapy (PORT) in small oral squamous cell carcinomas (SCC). Methods: Retrospective analysis of DOI (<5, 5 to <10, ≥10 mm) and disease-specific survival (DSS) in a multi-institutional international cohort of 1409 patients with oral SCC ≤4 cm in size treated between 1990-2011. Results: In patients without other adverse factors (nodal metastases; close [<5 mm] or involved margins), there was no association between DOI and DSS, with an excellent prognosis irrespective of depth. In the absence of PORT, the 5-year disease-specific mortality was 10% with DOI ≥10 mm, 8% with DOI 5-10 mm, and 6% with DOI <5 mm (P =.169), yielding an absolute risk difference of only 4%. Conclusion: The deterioration in prognosis with increasing DOI largely reflects an association with other adverse features. In the absence of these, depth alone should not be an indication for PORT outside a clinical trial.

Original language	English
Pages (from-to)	1935-1942
Number of pages	8
Journal	Head and Neck
Volume	41
Issue number	6
DOIs	https://doi.org/10.1002/hed.25633
Publication status	Published - 1 Jun 2019

Keywords

depth of invasion
head and neck cancer
locoregional control
oral squamous cell carcinoma
radiotherapy
survival
tumor thickness

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Ebrahimi, A., Gil, Z., Amit, M., Yen, T. C., Liao, C., Chaturvedi, P., Agarwal, J. P., Kowalski, L. P., Köhler, H. F., Kreppel, M., Cernea, C. R., Brandao, J., Bachar, G., Villaret, A. B., Fliss, D. M., Fridman, E., Robbins, K. T., Shah, J. P., Patel, S. G., ... The International Consortium for Outcome Research (ICOR) in Head and Neck Cancer (2019). Depth of invasion alone as an indication for postoperative radiotherapy in small oral squamous cell carcinomas: an international collaborative study. Head and Neck, 41(6), 1935-1942. https://doi.org/10.1002/hed.25633

@article{2d6f313715424827bf33e162868735d8,

title = "Depth of invasion alone as an indication for postoperative radiotherapy in small oral squamous cell carcinomas: an international collaborative study",

abstract = "Background: We aimed to investigate whether depth of invasion (DOI) should be an independent indication for postoperative radiotherapy (PORT) in small oral squamous cell carcinomas (SCC). Methods: Retrospective analysis of DOI (<5, 5 to <10, ≥10 mm) and disease-specific survival (DSS) in a multi-institutional international cohort of 1409 patients with oral SCC ≤4 cm in size treated between 1990-2011. Results: In patients without other adverse factors (nodal metastases; close [<5 mm] or involved margins), there was no association between DOI and DSS, with an excellent prognosis irrespective of depth. In the absence of PORT, the 5-year disease-specific mortality was 10% with DOI ≥10 mm, 8% with DOI 5-10 mm, and 6% with DOI <5 mm (P =.169), yielding an absolute risk difference of only 4%. Conclusion: The deterioration in prognosis with increasing DOI largely reflects an association with other adverse features. In the absence of these, depth alone should not be an indication for PORT outside a clinical trial.",

keywords = "depth of invasion, head and neck cancer, locoregional control, oral squamous cell carcinoma, radiotherapy, survival, tumor thickness",

author = "Ardalan Ebrahimi and Ziv Gil and Moran Amit and Yen, {Tzu Chen} and Chun-ta Liao and Pankaj Chaturvedi and Agarwal, {Jai Prakash} and Kowalski, {Luiz P.} and K{\"o}hler, {Hugo F.} and Matthias Kreppel and Cernea, {Claudio R.} and Jason Brandao and Gideon Bachar and Villaret, {Andrea Bolzoni} and Fliss, {Dan M.} and Eran Fridman and Robbins, {Kevin Thomas} and Shah, {Jatin P.} and Patel, {Snehal G.} and Clark, {Jonathan R.} and {The International Consortium for Outcome Research (ICOR) in Head and Neck Cancer}",

year = "2019",

month = jun,

day = "1",

doi = "10.1002/hed.25633",

language = "English",

volume = "41",

pages = "1935--1942",

journal = "Head and Neck",

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Ebrahimi, A, Gil, Z, Amit, M, Yen, TC, Liao, C, Chaturvedi, P, Agarwal, JP, Kowalski, LP, Köhler, HF, Kreppel, M, Cernea, CR, Brandao, J, Bachar, G, Villaret, AB, Fliss, DM, Fridman, E, Robbins, KT, Shah, JP, Patel, SG, Clark, JR & The International Consortium for Outcome Research (ICOR) in Head and Neck Cancer 2019, 'Depth of invasion alone as an indication for postoperative radiotherapy in small oral squamous cell carcinomas: an international collaborative study', Head and Neck, vol. 41, no. 6, pp. 1935-1942. https://doi.org/10.1002/hed.25633

TY - JOUR

T1 - Depth of invasion alone as an indication for postoperative radiotherapy in small oral squamous cell carcinomas

T2 - an international collaborative study

AU - Ebrahimi, Ardalan

AU - Gil, Ziv

AU - Amit, Moran

AU - Yen, Tzu Chen

AU - Liao, Chun-ta

AU - Chaturvedi, Pankaj

AU - Agarwal, Jai Prakash

AU - Kowalski, Luiz P.

AU - Köhler, Hugo F.

AU - Kreppel, Matthias

AU - Cernea, Claudio R.

AU - Brandao, Jason

AU - Bachar, Gideon

AU - Villaret, Andrea Bolzoni

AU - Fliss, Dan M.

AU - Fridman, Eran

AU - Robbins, Kevin Thomas

AU - Shah, Jatin P.

AU - Patel, Snehal G.

AU - Clark, Jonathan R.

AU - The International Consortium for Outcome Research (ICOR) in Head and Neck Cancer

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Background: We aimed to investigate whether depth of invasion (DOI) should be an independent indication for postoperative radiotherapy (PORT) in small oral squamous cell carcinomas (SCC). Methods: Retrospective analysis of DOI (<5, 5 to <10, ≥10 mm) and disease-specific survival (DSS) in a multi-institutional international cohort of 1409 patients with oral SCC ≤4 cm in size treated between 1990-2011. Results: In patients without other adverse factors (nodal metastases; close [<5 mm] or involved margins), there was no association between DOI and DSS, with an excellent prognosis irrespective of depth. In the absence of PORT, the 5-year disease-specific mortality was 10% with DOI ≥10 mm, 8% with DOI 5-10 mm, and 6% with DOI <5 mm (P =.169), yielding an absolute risk difference of only 4%. Conclusion: The deterioration in prognosis with increasing DOI largely reflects an association with other adverse features. In the absence of these, depth alone should not be an indication for PORT outside a clinical trial.

AB - Background: We aimed to investigate whether depth of invasion (DOI) should be an independent indication for postoperative radiotherapy (PORT) in small oral squamous cell carcinomas (SCC). Methods: Retrospective analysis of DOI (<5, 5 to <10, ≥10 mm) and disease-specific survival (DSS) in a multi-institutional international cohort of 1409 patients with oral SCC ≤4 cm in size treated between 1990-2011. Results: In patients without other adverse factors (nodal metastases; close [<5 mm] or involved margins), there was no association between DOI and DSS, with an excellent prognosis irrespective of depth. In the absence of PORT, the 5-year disease-specific mortality was 10% with DOI ≥10 mm, 8% with DOI 5-10 mm, and 6% with DOI <5 mm (P =.169), yielding an absolute risk difference of only 4%. Conclusion: The deterioration in prognosis with increasing DOI largely reflects an association with other adverse features. In the absence of these, depth alone should not be an indication for PORT outside a clinical trial.

KW - depth of invasion

KW - head and neck cancer

KW - locoregional control

KW - oral squamous cell carcinoma

KW - radiotherapy

KW - survival

KW - tumor thickness

UR - http://www.scopus.com/inward/record.url?scp=85062373816&partnerID=8YFLogxK

U2 - 10.1002/hed.25633

DO - 10.1002/hed.25633

M3 - Article

C2 - 30801885

AN - SCOPUS:85062373816

VL - 41

SP - 1935

EP - 1942

JO - Head and Neck

JF - Head and Neck

SN - 1043-3074

IS - 6

ER -

Depth of invasion alone as an indication for postoperative radiotherapy in small oral squamous cell carcinomas: an international collaborative study

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