Patients of stage I oral cancer with pathologically low-risk feature managed by primary tumor resection alone: Impact of depth of invasion and a nomogram analysis

Ming Hsien Tsai, Hui Shan Huang, Hui Ching Chuang, Yu Tsai Lin, Kun Lin Yang, Hui Lu, Chih Yen Chien*

*此作品的通信作者

研究成果: 期刊稿件文章同行評審

2 引文 斯高帕斯(Scopus)

摘要

Objectives: To evaluate the importance of depth of invasion (DOI) in patients with pathologically low-risk feature stage I oral squamous cell carcinoma (OSCC) managed by primary tumor resection alone. Methods: Patients with stage I OSCC, at pathologically low risk, underwent primary tumor resection without neck dissection were enrolled retrospectively between 2007 and 2015. Low risk was defined as the absence of positive or close margins, lymphovascular invasion, perineural invasion, worst pattern of invasion-5, and poor differentiation in histologic grade. The primary endpoints included overall survival (OS), cancer specific survival (CSS), local recurrence free survival (LRFS), and regional recurrence free survival (RRFS). A nomogram based on the DOI was established for predicting RRFS. Results: A total of 198 patients were enrolled in this study. DOI was the only prognosticator to achieve statistical significance in all primary endpoints according to univariate analysis. Patients with DOI <3 mm tumor showed better five-year OS, CSS, LRFS, and RRFS than those with DOI ≥3 mm tumor. The concordance index of the nomogram model without DOI was 0.684, which could increase to 0.733 when DOI was included in the calculation. Conclusion: Patients with pathologically low-risk stage I OSCC correlate with a higher chance in occult neck metastasis if increasing DOI (≥3 mm) is noticed. Indeed, the chance of occult neck metastasis is significantly higher in this group (14% vs. 2%) than in those with DOI <3 mm. Elective neck dissection is advised if DOI is ≥3 mm to achieve better clinical outcomes. Level of Evidence: 4.

原文英語
頁(從 - 到)1025-1032
頁數8
期刊Laryngoscope Investigative Otolaryngology
7
發行號4
DOIs
出版狀態已出版 - 08 2022

文獻附註

Publisher Copyright:
© 2022 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society.

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