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Long‐term survival in locally advanced oral cavity cancer: An analysis of patients treated with neoadjuvant cisplatin‐based chemotherapy followed by surgery
Author(s) -
Ruggeri Enzo Maria,
Carlini Paolo,
Pollera Camillo Francesco,
De Marco Salvatore,
Ruscito Paolo,
Pinnarò Paola,
Nardi Mario,
Giannarelli Diana,
Cognetti Francesco
Publication year - 2005
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20190
Subject(s) - medicine , chemotherapy , hazard ratio , univariate analysis , proportional hazards model , radiation therapy , surgery , stage (stratigraphy) , oncology , head and neck cancer , cancer , survival analysis , multivariate analysis , confidence interval , paleontology , biology
Background. Neoadjuvant chemotherapy has been reported to be extremely active in head and neck cancer but has failed to give a statistically significant improvement in survival. Methods. From 1981 to 1994, 33 operable patients with locally advanced oral cavity cancer received cisplatin‐based chemotherapy before surgery. Postoperative radiotherapy was performed in high‐risk patients. Results. The overall clinical and pathologic complete response rates to neoadjuvant chemotherapy were 48% and 30%, respectively. At a median follow‐up of 7.0 years (range, 0.3–15.3+ years), the 5‐year and 10‐year overall survival rates were 54.5% and 39.5%, and the disease‐specific median survival was 6.6 years for all patients (8.3 and 2.3 years for stages III and IV, respectively). The univariate analysis showed a positive relationship between survival and male sex ( p = .05), pathologic ( p = .02), and clinical ( p = .03) complete response. The Cox proportional hazard regression model confirmed the independent prognostic value of the clinical response with a 4.67 (95% CI, 1.70–12.86) hazard ratio. A second primary tumor occurred in six patients (18%), with a median of occurrence of 9 years (range, 7–11 years). Conclusions. This study confirms the prolonged survival expectancy largely exceeding 5 years for selected patients with stage IV and for most with stage III locally advanced oral cavity cancer achieving a clinical and/or pathologic complete response to chemotherapy. © 2005 Wiley Periodicals, Inc. Head Neck 27: XXX–XXX, 2005