A comparison of outcomes for patients with oral squamous cell carcinoma at intermediate risk of recurrence treated by surgery alone or with post-operative radiotherapy

Brown, J., Blackburn, T., Woolgar, J., Lowe, D., Errington, R., Vaughan, E. and Rogers, S. (2007) A comparison of outcomes for patients with oral squamous cell carcinoma at intermediate risk of recurrence treated by surgery alone or with post-operative radiotherapy. Oral Oncology, 43 (8). pp. 764-773. ISSN 1368-8375 DOI https://doi.org/10.1016/j.oraloncology.2006.09.010

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Abstract

Controversy remains about which patients at intermediate risk of recurrence of oral squamous cell carcinoma would benefit from radiotherapy. A retrospective review of computerised database and medical records for 462 consecutive patients at the Regional Maxillofacial Unit in Liverpool who were treated with primary surgery with or without post-operative radiotherapy was carried out. We classified 29% (134) of patients as being at ‘low’ risk of disease recurrence (pT1-2, N0 with clear margins), 29% (135) at ‘high’ risk (involved margins or lymph node extracapsular spread) and the remaining 42% (193) at ‘intermediate’ risk. Of those at intermediate risk, 41% (80/193) received adjuvant radiotherapy and their 5 year survival (SE) was 54% (6%) compared to 71% (5%) for those with primary surgery alone (P = 0.002). A higher proportion of patients having radiotherapy had loco-regional recurrence (19/80 24%) compared to those treated by surgery alone (17/113 15%). The improved salvage rate for recurrent disease in the surgery alone group (8/17 53%), compared to those receiving radiotherapy (2/19 13%, P = 0.05), indicates an advantage in withholding radiotherapy for patients at intermediate risk of recurrence. This study indicates a potential disadvantage associated with the use of postoperative radiotherapy for patients at intermediate risk of recurrence. A randomised trial comparing a watch and wait policy to postoperative radiotherapy in patients with an intermediate risk of recurrence is required to confirm the trend indicated in this retrospective data

Item Type: Article
Subjects: R Medicine > RD Surgery
R Medicine > RF Otorhinolaryngology
Divisions: Nursing and Midwifery
Date Deposited: 20 Oct 2010 12:44
URI: http://repository.edgehill.ac.uk/id/eprint/1076

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