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 & 1 others The International Consortium for Outcome Research (ICOR) in Head and Neck Cancer

*Corresponding author for this work

Research output: Contribution to journalArticle

9 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 languageEnglish
Pages (from-to)1935-1942
Number of pages8
JournalHead and Neck
Volume41
Issue number6
DOIs
Publication statusPublished - 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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