Clinical Outcomes of Taiwanese Patients with cT4 Oral Cavity Squamous Cell Carcinoma: Toward the Identification of the Optimal Initial Treatment Approach for cT4b Patients

Chun Ta Liao, Yu Wen Wen, Shu Ru Lee, Tsang Wu Liu, Sen Tien Tsai, Ming Hsui Tsai, Jin Ching Lin, Pei Jen Lou, Pen Yuan Chu, Yi Shing Leu, Kuo Yang Tsai, Shyuang Der Terng, Tsung-Ming Chen, Cheng Hsu Wang, Chih Yen Chien, Wen Cheng Chen, Li Yu Lee, Chien Yu Lin, Hung Ming Wang, Shu Hang NgChih Hung Lin, Tuan Jen Fang, Shiang Fu Huang, Chung Jan Kang, Kai Ping Chang, Lan Yan Yang, Tzu Chen Yen, the Taiwan Oral Cancer Advisory Group for the Taiwan Oral Cancer Advisory Group

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: The National Comprehensive Cancer Network guidelines recommend that patients with oral cavity squamous cell carcinoma (OSCC) and cT4b disease should be either included in clinical trials or treated with a nonsurgical approach. However, surgery may be feasible in selected patients with adequate safety margins. Using the nationwide Taiwanese Cancer Registry Database, we examined the prognosis of cT4b OSCC patients in relation to their treatment approach. Methods: Of the 18,910 patients with previously untreated first primary OSCC identified between 2004 and 2010, 492 (2.6 %) had cT4b tumors. Of them, 327 (66 %) received initial treatment with surgery, whereas 165 (34 %) were initially treated with a nonsurgical approach. Of the latter group, 78 patients subsequently underwent surgery. A 5-year disease-specific survival (DSS) ≥45 % was considered as a favorable outcome. Results: Better 5-year DSS and overall survival (OS) rates were observed in cT4b patients initially treated with surgery (vs. nonsurgery; DSS, 51 vs. 38 %; OS, 43 vs. 27 %, respectively, p < 0.001). Of the participants initially treated with surgery, patients with cN0–2 disease had better 5-year survival rates (DSS: cN0, 59 %; cN1, 53 %; cN2, 46 %; OS: cN0, 49 %; cN1, 50 %; cN2, 37 %) than those with cN3 disease (DSS: 0 %; OS: 0 %). Among cT4b patients who initially received a nonsurgical treatment, subjects who subsequently underwent surgery showed better outcomes. Conclusions: Primary surgery is performed in approximately two-thirds of cT4b OSCC patients, with cN0–2 cases showing a good prognosis. Patients who initially received a nonsurgical approach can subsequently be treated with surgery and achieve favorable outcomes.

Original languageEnglish
Pages (from-to)785-793
Number of pages9
JournalAnnals of Surgical Oncology
Volume24
Issue number3
DOIs
Publication statusPublished - Mar 1 2017

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Mouth
Squamous Cell Carcinoma
Survival
Therapeutics
Survival Rate
Neoplasms
Registries
Clinical Trials
Databases
Guidelines
Safety

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Liao, C. T., Wen, Y. W., Lee, S. R., Liu, T. W., Tsai, S. T., Tsai, M. H., ... for the Taiwan Oral Cancer Advisory Group, T. T. O. C. A. G. (2017). Clinical Outcomes of Taiwanese Patients with cT4 Oral Cavity Squamous Cell Carcinoma: Toward the Identification of the Optimal Initial Treatment Approach for cT4b Patients. Annals of Surgical Oncology, 24(3), 785-793. https://doi.org/10.1245/s10434-016-5629-x

Clinical Outcomes of Taiwanese Patients with cT4 Oral Cavity Squamous Cell Carcinoma : Toward the Identification of the Optimal Initial Treatment Approach for cT4b Patients. / Liao, Chun Ta; Wen, Yu Wen; Lee, Shu Ru; Liu, Tsang Wu; Tsai, Sen Tien; Tsai, Ming Hsui; Lin, Jin Ching; Lou, Pei Jen; Chu, Pen Yuan; Leu, Yi Shing; Tsai, Kuo Yang; Terng, Shyuang Der; Chen, Tsung-Ming; Wang, Cheng Hsu; Chien, Chih Yen; Chen, Wen Cheng; Lee, Li Yu; Lin, Chien Yu; Wang, Hung Ming; Ng, Shu Hang; Lin, Chih Hung; Fang, Tuan Jen; Huang, Shiang Fu; Kang, Chung Jan; Chang, Kai Ping; Yang, Lan Yan; Yen, Tzu Chen; for the Taiwan Oral Cancer Advisory Group, the Taiwan Oral Cancer Advisory Group.

In: Annals of Surgical Oncology, Vol. 24, No. 3, 01.03.2017, p. 785-793.

Research output: Contribution to journalArticle

Liao, CT, Wen, YW, Lee, SR, Liu, TW, Tsai, ST, Tsai, MH, Lin, JC, Lou, PJ, Chu, PY, Leu, YS, Tsai, KY, Terng, SD, Chen, T-M, Wang, CH, Chien, CY, Chen, WC, Lee, LY, Lin, CY, Wang, HM, Ng, SH, Lin, CH, Fang, TJ, Huang, SF, Kang, CJ, Chang, KP, Yang, LY, Yen, TC & for the Taiwan Oral Cancer Advisory Group, TTOCAG 2017, 'Clinical Outcomes of Taiwanese Patients with cT4 Oral Cavity Squamous Cell Carcinoma: Toward the Identification of the Optimal Initial Treatment Approach for cT4b Patients', Annals of Surgical Oncology, vol. 24, no. 3, pp. 785-793. https://doi.org/10.1245/s10434-016-5629-x
Liao, Chun Ta ; Wen, Yu Wen ; Lee, Shu Ru ; Liu, Tsang Wu ; Tsai, Sen Tien ; Tsai, Ming Hsui ; Lin, Jin Ching ; Lou, Pei Jen ; Chu, Pen Yuan ; Leu, Yi Shing ; Tsai, Kuo Yang ; Terng, Shyuang Der ; Chen, Tsung-Ming ; Wang, Cheng Hsu ; Chien, Chih Yen ; Chen, Wen Cheng ; Lee, Li Yu ; Lin, Chien Yu ; Wang, Hung Ming ; Ng, Shu Hang ; Lin, Chih Hung ; Fang, Tuan Jen ; Huang, Shiang Fu ; Kang, Chung Jan ; Chang, Kai Ping ; Yang, Lan Yan ; Yen, Tzu Chen ; for the Taiwan Oral Cancer Advisory Group, the Taiwan Oral Cancer Advisory Group. / Clinical Outcomes of Taiwanese Patients with cT4 Oral Cavity Squamous Cell Carcinoma : Toward the Identification of the Optimal Initial Treatment Approach for cT4b Patients. In: Annals of Surgical Oncology. 2017 ; Vol. 24, No. 3. pp. 785-793.
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title = "Clinical Outcomes of Taiwanese Patients with cT4 Oral Cavity Squamous Cell Carcinoma: Toward the Identification of the Optimal Initial Treatment Approach for cT4b Patients",
abstract = "Background: The National Comprehensive Cancer Network guidelines recommend that patients with oral cavity squamous cell carcinoma (OSCC) and cT4b disease should be either included in clinical trials or treated with a nonsurgical approach. However, surgery may be feasible in selected patients with adequate safety margins. Using the nationwide Taiwanese Cancer Registry Database, we examined the prognosis of cT4b OSCC patients in relation to their treatment approach. Methods: Of the 18,910 patients with previously untreated first primary OSCC identified between 2004 and 2010, 492 (2.6 {\%}) had cT4b tumors. Of them, 327 (66 {\%}) received initial treatment with surgery, whereas 165 (34 {\%}) were initially treated with a nonsurgical approach. Of the latter group, 78 patients subsequently underwent surgery. A 5-year disease-specific survival (DSS) ≥45 {\%} was considered as a favorable outcome. Results: Better 5-year DSS and overall survival (OS) rates were observed in cT4b patients initially treated with surgery (vs. nonsurgery; DSS, 51 vs. 38 {\%}; OS, 43 vs. 27 {\%}, respectively, p < 0.001). Of the participants initially treated with surgery, patients with cN0–2 disease had better 5-year survival rates (DSS: cN0, 59 {\%}; cN1, 53 {\%}; cN2, 46 {\%}; OS: cN0, 49 {\%}; cN1, 50 {\%}; cN2, 37 {\%}) than those with cN3 disease (DSS: 0 {\%}; OS: 0 {\%}). Among cT4b patients who initially received a nonsurgical treatment, subjects who subsequently underwent surgery showed better outcomes. Conclusions: Primary surgery is performed in approximately two-thirds of cT4b OSCC patients, with cN0–2 cases showing a good prognosis. Patients who initially received a nonsurgical approach can subsequently be treated with surgery and achieve favorable outcomes.",
author = "Liao, {Chun Ta} and Wen, {Yu Wen} and Lee, {Shu Ru} and Liu, {Tsang Wu} and Tsai, {Sen Tien} and Tsai, {Ming Hsui} and Lin, {Jin Ching} and Lou, {Pei Jen} and Chu, {Pen Yuan} and Leu, {Yi Shing} and Tsai, {Kuo Yang} and Terng, {Shyuang Der} and Tsung-Ming Chen and Wang, {Cheng Hsu} and Chien, {Chih Yen} and Chen, {Wen Cheng} and Lee, {Li Yu} and Lin, {Chien Yu} and Wang, {Hung Ming} and Ng, {Shu Hang} and Lin, {Chih Hung} and Fang, {Tuan Jen} and Huang, {Shiang Fu} and Kang, {Chung Jan} and Chang, {Kai Ping} and Yang, {Lan Yan} and Yen, {Tzu Chen} and {for the Taiwan Oral Cancer Advisory Group}, {the Taiwan Oral Cancer Advisory Group}",
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T1 - Clinical Outcomes of Taiwanese Patients with cT4 Oral Cavity Squamous Cell Carcinoma

T2 - Toward the Identification of the Optimal Initial Treatment Approach for cT4b Patients

AU - Liao, Chun Ta

AU - Wen, Yu Wen

AU - Lee, Shu Ru

AU - Liu, Tsang Wu

AU - Tsai, Sen Tien

AU - Tsai, Ming Hsui

AU - Lin, Jin Ching

AU - Lou, Pei Jen

AU - Chu, Pen Yuan

AU - Leu, Yi Shing

AU - Tsai, Kuo Yang

AU - Terng, Shyuang Der

AU - Chen, Tsung-Ming

AU - Wang, Cheng Hsu

AU - Chien, Chih Yen

AU - Chen, Wen Cheng

AU - Lee, Li Yu

AU - Lin, Chien Yu

AU - Wang, Hung Ming

AU - Ng, Shu Hang

AU - Lin, Chih Hung

AU - Fang, Tuan Jen

AU - Huang, Shiang Fu

AU - Kang, Chung Jan

AU - Chang, Kai Ping

AU - Yang, Lan Yan

AU - Yen, Tzu Chen

AU - for the Taiwan Oral Cancer Advisory Group, the Taiwan Oral Cancer Advisory Group

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Background: The National Comprehensive Cancer Network guidelines recommend that patients with oral cavity squamous cell carcinoma (OSCC) and cT4b disease should be either included in clinical trials or treated with a nonsurgical approach. However, surgery may be feasible in selected patients with adequate safety margins. Using the nationwide Taiwanese Cancer Registry Database, we examined the prognosis of cT4b OSCC patients in relation to their treatment approach. Methods: Of the 18,910 patients with previously untreated first primary OSCC identified between 2004 and 2010, 492 (2.6 %) had cT4b tumors. Of them, 327 (66 %) received initial treatment with surgery, whereas 165 (34 %) were initially treated with a nonsurgical approach. Of the latter group, 78 patients subsequently underwent surgery. A 5-year disease-specific survival (DSS) ≥45 % was considered as a favorable outcome. Results: Better 5-year DSS and overall survival (OS) rates were observed in cT4b patients initially treated with surgery (vs. nonsurgery; DSS, 51 vs. 38 %; OS, 43 vs. 27 %, respectively, p < 0.001). Of the participants initially treated with surgery, patients with cN0–2 disease had better 5-year survival rates (DSS: cN0, 59 %; cN1, 53 %; cN2, 46 %; OS: cN0, 49 %; cN1, 50 %; cN2, 37 %) than those with cN3 disease (DSS: 0 %; OS: 0 %). Among cT4b patients who initially received a nonsurgical treatment, subjects who subsequently underwent surgery showed better outcomes. Conclusions: Primary surgery is performed in approximately two-thirds of cT4b OSCC patients, with cN0–2 cases showing a good prognosis. Patients who initially received a nonsurgical approach can subsequently be treated with surgery and achieve favorable outcomes.

AB - Background: The National Comprehensive Cancer Network guidelines recommend that patients with oral cavity squamous cell carcinoma (OSCC) and cT4b disease should be either included in clinical trials or treated with a nonsurgical approach. However, surgery may be feasible in selected patients with adequate safety margins. Using the nationwide Taiwanese Cancer Registry Database, we examined the prognosis of cT4b OSCC patients in relation to their treatment approach. Methods: Of the 18,910 patients with previously untreated first primary OSCC identified between 2004 and 2010, 492 (2.6 %) had cT4b tumors. Of them, 327 (66 %) received initial treatment with surgery, whereas 165 (34 %) were initially treated with a nonsurgical approach. Of the latter group, 78 patients subsequently underwent surgery. A 5-year disease-specific survival (DSS) ≥45 % was considered as a favorable outcome. Results: Better 5-year DSS and overall survival (OS) rates were observed in cT4b patients initially treated with surgery (vs. nonsurgery; DSS, 51 vs. 38 %; OS, 43 vs. 27 %, respectively, p < 0.001). Of the participants initially treated with surgery, patients with cN0–2 disease had better 5-year survival rates (DSS: cN0, 59 %; cN1, 53 %; cN2, 46 %; OS: cN0, 49 %; cN1, 50 %; cN2, 37 %) than those with cN3 disease (DSS: 0 %; OS: 0 %). Among cT4b patients who initially received a nonsurgical treatment, subjects who subsequently underwent surgery showed better outcomes. Conclusions: Primary surgery is performed in approximately two-thirds of cT4b OSCC patients, with cN0–2 cases showing a good prognosis. Patients who initially received a nonsurgical approach can subsequently be treated with surgery and achieve favorable outcomes.

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