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Depth of invasion alone as an indication for postoperative radiotherapy in small oral squamous cell carcinomas: An International Collaborative Study
Author(s) -
Ebrahimi Ardalan,
Gil Ziv,
Amit Moran,
Yen TzuChen,
Liao Chunta,
Chaturvedi Pankaj,
Agarwal Jai Prakash,
Kowalski Luiz P.,
Köhler Hugo F.,
Kreppel Matthias,
Cernea Claudio R.,
Brandao Jason,
Bachar Gideon,
Villaret Andrea Bolzoni,
Fliss Dan M.,
Fridman Eran,
Robbins Kevin Thomas,
Shah Jatin P.,
Patel Snehal G.,
Clark Jonathan R.
Publication year - 2019
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.25633
Subject(s) - medicine , port (circuit theory) , adverse effect , retrospective cohort study , radiation therapy , cohort , oncology , basal cell , surgery , gastroenterology , electrical engineering , engineering
Background We aimed to investigate whether depth of invasion (DOI) should be an independent indication for postoperative radiotherapy (PORT) in small oral squamous cell carcinomas (SCC). Methods Retrospective analysis of DOI (<5, 5 to <10, ≥10 mm) and disease‐specific survival (DSS) in a multi‐institutional international cohort of 1409 patients with oral SCC ≤4 cm in size treated between 1990‐2011. Results In patients without other adverse factors (nodal metastases; close [<5 mm] or involved margins), there was no association between DOI and DSS, with an excellent prognosis irrespective of depth. In the absence of PORT, the 5‐year disease‐specific mortality was 10% with DOI ≥10 mm, 8% with DOI 5‐10 mm, and 6% with DOI <5 mm ( P = .169), yielding an absolute risk difference of only 4%. Conclusion The deterioration in prognosis with increasing DOI largely reflects an association with other adverse features. In the absence of these, depth alone should not be an indication for PORT outside a clinical trial.