Evidence map›Paper›PMID 39456017›Full record

ArticleBMC cancer2024

Prognostic significance of adjuvant therapy and specific radiation dosages in Taiwanese patients with oral cavity cancer and extra-nodal extension: a nationwide cohort study.

Yao-Te Tsai, Wen-Cheng Chen, Yu-Wen Wen, Chien-Yu Lin, Kang-Hsing Fan, Jin-Ching Lin, Shu-Hang Ng, Shu-Ru Lee, Chung-Jan Kang, Li-Yu Lee and 21 more

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Article in BMC cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

31 authors.

Yao-Te Tsai *Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC.
Wen-Cheng Chen *Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi and Chang Gung University, Taoyuan, Taiwan, ROC.
Yu-Wen Wen *Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan, ROC.
Chien-Yu LinDepartment of Radiation Oncology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
Kang-Hsing FanDepartment of Radiation Oncology, New Taipei Municipal TuCheng Hospital, New Taipei City, Taiwan, ROC.
Jin-Ching LinDepartment of Radiation Oncology, Changhua Christian Hospital, Changhua, Taiwan, ROC.
Shu-Hang NgDepartment of Diagnostic Radiology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
Shu-Ru LeeResearch Service Center for Health Information, Chang Gung University, Taoyuan Taiwan, ROC.
Chung-Jan KangDepartment of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
Li-Yu LeeDepartment of Pathology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
Chih-Yen ChienDoctoral Program of Clinical and Experimental Medicine, Kaohsiung Chang Gung Memorial Hospital, National Sun Yat-sen University, Taiwan, ROC.
Chun-Hung HuaDepartment of Otorhinolaryngology, China Medical University Hospital, Taichung, Taiwan, ROC.
Cheng Ping WangDepartment of Otolaryngology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan, ROC.
Tsung-Ming ChenDepartment of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, ROC.
Shyuang-Der TerngDepartment of Head and Neck Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan, ROC.
Chi-Ying TsaiDepartment of Oral and Maxillofacial Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
Hung-Ming WangDepartment of Medical Oncology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
Chia-Hsun HsiehDepartment of Medical Oncology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
Chih-Hua YehDepartment of Diagnostic Radiology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
Chih-Hung LinDepartment of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.
Chung-Kan TsaoDepartment of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.
Nai-Ming ChengDepartment of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
Tuan-Jen FangDepartment of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
Shiang-Fu HuangDepartment of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
Li-Ang LeeDepartment of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
Ku-Hao FangDepartment of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
Yu-Chien WangDepartment of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
Wan-Ni LinDepartment of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
Li-Jen HsinDepartment of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
Tzu-Chen YenDepartment of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC.
Chun-Ta LiaoDepartment of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan, ROC. liaoct@cgmh.org.tw.

Funding

Chang Gung Memorial Hospital, Linkou CMRPD1H0521
6 · The paper itself

Abstract

backgroundThe evidence for adjuvant chemoradiotherapy (CRT) of oral cavity squamous cell carcinoma (OCSCC) with extra-nodal extension (ENE) in National Comprehensive Cancer Network (NCCN) guidelines is derived from patients with head and neck cancer. The guidelines further suggest a radiation dose ranging from 6000 to 6600 cGy. In this nationwide study, we sought to evaluate the prognostic significance of adjuvant therapy and the specific radiation dosage in Taiwanese patients with pure OCSCC and ENE.

methodsA retrospective analysis of 1577 OCSCC patients with ENE who underwent resection and received adjuvant CRT or radiotherapy (RT) between January 2011 and December 2020 was conducted.

resultsMultivariable analysis revealed that adjuvant RT, more than four pathologically positive nodes, and radiation dosage below 6000 cGy were independent risk factors for unfavorable 5-year disease-specific survival (DSS) and overall survival (OS). Comparing patients who received CRT (n = 1453) to those treated with RT (n = 124) before and after propensity score (PS) matching, the 5-year outcomes were as follows: before PS matching, DSS (54% versus 30%, p < 0.0001), OS (42% versus 18%, p < 0.0001); after PS matching (n = 111 in each group), DSS (52% versus 30%, p = 0.0016), OS (38% versus 21%, p = 0.0019). For patients who underwent CRT, the 5-year outcomes for different radiation dose groups (6600 - 7000 cGy, n = 1155 versus 6000 - 6500 cGy, n = 199) were as follows: before PS matching, DSS (52% versus 54%, p = 0.1904), OS (43% versus 46%, p = 0.1610); after PS matching (n = 199 in each group), DSS (55% versus 54%, p = 0.8374), OS (46.5% versus 46.3%, p = 0.7578).

conclusionsFor OCSCC patients with ENE, our study shows CRT improved survivals than RT alone, underscoring the clinical significance of chemotherapy. Patients undergoing CRT with irradiation doses ranging from 6000 to 6500 cGy exhibited comparable survival outcomes to those receiving doses of 6600-7000 cGy. This observation suggests that irradiation doses exceeding the 6600 cGy may not confer the survival advantage in these patients. Further research is needed to confirm our results and explore the optimal irradiation dose for managing these patients.

Indexed as

Chemoradiotherapy, AdjuvantMouth NeoplasmsAdultAgedExtranodal ExtensionFemaleHumansMaleMiddle AgedPrognosisRadiotherapy DosageRetrospective StudiesSquamous Cell Carcinoma of Head and NeckTaiwanCancer registryChemoradiotherapyExtra-nodal extensionOral cavity squamous cell carcinomaRadiotherapySurvival outcomes

Identifiers

PMID39456017
PMCPMC11515095

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.