Long-term survival in locally advanced oral cavity cancer: An analysis of patients treated with neoadjuvant cisplatin-based chemotherapy followed by surgery
✍ Scribed by Enzo Maria Ruggeri; Paolo Carlini; Camillo Francesco Pollera; Salvatore De Marco; Paolo Ruscito; Paola Pinnarò; Mario Nardi; Diana Giannarelli; Francesco Cognetti
- Publisher
- John Wiley and Sons
- Year
- 2005
- Tongue
- English
- Weight
- 172 KB
- Volume
- 27
- Category
- Article
- ISSN
- 1043-3074
No coin nor oath required. For personal study only.
✦ Synopsis
Background:
Neoadjuvant chemotherapy has been reported to be extremely active in head and neck cancer but has failed to give a statistically significant improvement in survival.
Methods:
From 1981 to 1994, 33 operable patients with locally advanced oral cavity cancer received cisplatin-based chemotherapy before surgery. postoperative radiotherapy was performed in high-risk patients.
Results:
The overall clinical and pathologic complete response rates to neoadjuvant chemotherapy were 48% and 30%, respectively. at a median follow-up of 7.0 years (range, 0.3-15.3+ years), the 5-year and 10-year overall survival rates were 54.5% and 39.5%, and the disease-specific median survival was 6.6 years for all patients (8.3 and 2.3 years for stages iii and iv, respectively). the univariate analysis showed a positive relationship between survival and male sex (p = .05), pathologic (p = .02), and clinical (p = .03) complete response. the cox proportional hazard regression model confirmed the independent prognostic value of the clinical response with a 4.67 (95% ci, 1.70-12.86) hazard ratio. a second primary tumor occurred in six patients (18%), with a median of occurrence of 9 years (range, 7-11 years).
Conclusions:
This study confirms the prolonged survival expectancy largely exceeding 5 years for selected patients with stage iv and for most with stage iii locally advanced oral cavity cancer achieving a clinical and/or pathologic complete response to chemotherapy.