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Survival outcomes for postoperative chemoradiation in intermediate‐risk oral tongue cancers
Author(s) -
Spiotto Michael T.,
Jefferson Gina D.,
Wenig Barry,
Markiewicz Michael R.,
Weichselbaum Ralph R.,
Koshy Matthew
Publication year - 2017
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.24932
Subject(s) - medicine , tongue , hazard ratio , pathological , cohort , proportional hazards model , cancer , propensity score matching , oncology , surgery , confidence interval , pathology
Background The survival outcomes for surgery + postoperative radiotherapy (S+RT) or surgery + postoperative chemoradiation (S+CRT) was compared in patients having oral tongue cancers with intermediate‐risk pathological features. Methods Using the National Cancer Database (NCDB), overall survival (OS) for S+RT or S+CRT was estimated using the Kaplan‐Meier methods and Cox proportional hazard models in the entire population (n = 2803) and in a propensity‐matched cohort (n = 1136). Results The 3‐year OS was 73.3% for S+CRT versus 66.7% for S+RT ( P = .02). The S+CRT improved the 3‐year OS for patients with 2 or more involved metastatic lymph nodes (≥2 MLNs; P = .01) but not for patients with <2 MLNs ( P = .73). Undergoing S+CRT improved the 3‐year OS for patients with pathologic T classification (pT) pT3‐pT4 disease ( P = .01) but not for patients with pT1‐pT2 disease ( P = .18). Conclusion Undergoing S+CRT was associated with improved survival for patients with tongue cancers with ≥2 MLNs and/or pT3‐pT4 suggesting that specific intermediate‐risk pathological features benefit from treatment intensification.

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