Sharma Kanika, Ahlawat Parveen, Gairola Munish, Tandon Sarthak, Sachdeva Nishtha, Sharief Muhammed Ismail
Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India.
Radiat Oncol J. 2019 Jun;37(2):73-81. doi: 10.3857/roj.2018.00577. Epub 2019 Jun 30.
There is sparse literature on treatment outcomes research on resectable oral tongue squamous cell carcinoma (OTSCC). The aim of this study was to measure the treatment outcomes, explore the failure patterns, and identify the potential clinicopathological prognostic factors affecting treatment outcomes for resectable OTSCC.
It is a retrospective analysis of 202 patients with resectable OTSCC who underwent upfront primary surgical resection followed by adjuvant radiotherapy with or without concurrent chemotherapy if indicated.
The median follow-up was 35.2 months (range, 1.2 to 99.9 months). The median duration of locoregional control (LRC) was 84.9 months (95% confidence interval, 67.3-102.4). The 3- and 5-year LRC rate was 68.5% and 58.3%, respectively. Multivariate analysis showed that increasing pT stage, increasing pN stage, and the presence of extracapsular extension (ECE) were significantly associated with poorer LRC. The median duration of overall survival (OS) was not reached at the time of analysis. The 3- and 5-year OS rate was 70.5% and 66.6%, respectively. Multivariate analysis showed that increasing pT stage and the presence of ECE were significantly associated with a poorer OS.
Locoregional failure remains the main cause of treatment failure in resectable OTSCC. There is scope to further improve prognosis considering modest LRC and OS. Pathological T-stage, N-stage, and ECE are strong prognostic factors. Further research is required to confirm whether adjuvant therapy adds to treatment outcomes in cases with lymphovascular invasion, perineural invasion, and depth of invasion, and help clinicians tailoring adjuvant therapy.
关于可切除口腔舌鳞状细胞癌（OTSCC）治疗结果的研究文献较少。本研究旨在测量治疗结果，探索失败模式，并确定影响可切除OTSCC治疗结果的潜在临床病理预后因素。
这是一项对202例可切除OTSCC患者的回顾性分析，这些患者接受了 upfront 原发性手术切除，随后根据需要接受辅助放疗，有或无同步化疗。
中位随访时间为35.2个月（范围为1.2至99.9个月）。局部区域控制（LRC）的中位持续时间为84.9个月（95%置信区间，67.3 - 102.4）。3年和5年LRC率分别为68.5%和58.3%。多因素分析显示，pT分期增加、pN分期增加以及存在包膜外扩展（ECE）与较差的LRC显著相关。分析时总体生存（OS）的中位持续时间未达到。3年和5年OS率分别为70.5%和66.6%。多因素分析显示，pT分期增加和存在ECE与较差的OS显著相关。
局部区域失败仍然是可切除OTSCC治疗失败的主要原因。考虑到适度的LRC和OS，仍有进一步改善预后的空间。病理T分期、N分期和ECE是强有力的预后因素。需要进一步研究以确认辅助治疗在伴有脉管侵犯、神经侵犯和浸润深度的病例中是否能增加治疗效果，并帮助临床医生调整辅助治疗方案。
