A multicenter retrospective study on treatment outcomes of resected T4b oral squamous cell carcinoma

  • KAMATA Takahiro
    Department of Dentistry and Oral Surgery, Shinshu University School of Medicine
  • KURITA Hiroshi
    Department of Dentistry and Oral Surgery, Shinshu University School of Medicine
  • UEDA Michihiro
    Department of Oral and Maxillofacial Surgery, Keiyukai Sapporo Hospital
  • YAMASHITA Tetsuro
    Department of Oral and Maxillofacial Surgery, Keiyukai Sapporo Hospital
  • OTA Yoshihide
    Department of Oral and Maxillofacial Surgery, Division of Surgery, Tokai University School of Medicine
  • KIRITA Tadaaki
    Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University
  • OKURA Masaya
    First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University
  • UMEDA Masahiro
    Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences

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Other Title
  • 切除手術が行われたT4b口腔扁平上皮癌の治療成績に関する多施設共同後ろ向き研究
  • セツジョ シュジュツ ガ オコナワレタ T4b コウコウ ヘンペイ ジョウヒ ガン ノ チリョウ セイセキ ニ カンスル タシセツ キョウドウ ウシロ ムキ ケンキュウ

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Abstract

The TNM staging system suggests that advanced oral squamous cell carcinoma (OSCC) with T4b is often unresectable and its outcome is poor. The purpose of this multicenter retrospective study is to assess treatment outcomes of OSCC with T4b. Factors that influence treatment outcome were also analyzed.<br>Clinical and pathological data from 99 consecutive patients with resected T4b OSCC (years from 2000 through 2010) were reviewed and analyzed. The 5-year survival and control rates were the main outcome measures, and prognostic factors were identified by univariate and multivariate analyses.<br>All of the resected T4b tumors involved the masticator space, pterygoid plates, or both without carotid artery encasement and skull base extension. The 5-year overall survival, primary/neck control, and distant metastasis rates were 54.3%, 63.6%, and 18.1%, respectively. Multivariate analysis showed an independent and significant impact of the Eastern Cooperative Oncology Group performance status, mode of tumor invasion, and number/ level of metastatic lymph nodes on overall survival (Cox proportional-hazards model, p<0.01). Postoperative radiotherapy and adjuvant chemotherapy had a marginal impact (p=0.06).<br>The results of this study suggested that T4b OSCC involving only the masticator space, pterygoid plates, or both was resectable and expected to have a favorable outcome. Strategies to overcome highly invasive tumors and multiple lymph node metastases are required.

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