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Histopathological assessment of tumour regression, nodal stage and status of resection margins determines prognosis in patients with oral squamous cell carcinoma treated with neoadjuvant radiochemotherapy
Author(s) -
Wedemeyer I,
Kreppel M,
Scheer M,
Zöller JE,
Büttner R,
Drebber U
Publication year - 2014
Publication title -
oral diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.953
H-Index - 87
eISSN - 1601-0825
pISSN - 1354-523X
DOI - 10.1111/odi.12137
Subject(s) - medicine , stage (stratigraphy) , oncology , basal cell , nodal , neoadjuvant therapy , t stage , chemotherapy , resection , oral cancers , cancer , overall survival , surgery , biology , paleontology , breast cancer
Objectives In advanced oral squamous cell carcinoma ( OSCC ), tumour regression after neoadjuvant radiochemotherapy seems to be an important prognostic factor. In this study, we intended to compare regression grading according to two previously described regression models and to analyse the association of tumour regression and other tumour characteristics with patients' characteristics and overall survival. Methods The retrospective study included 63 treatment‐naive patients with primary OSCC of stages II ‐ IV , who were treated with a concomitant neoadjuvant radiochemotherapy followed by radical surgery. Assessment of histopathological features was performed, there under regression grading according to two previously described regression models. Results Both tumour regression models provided comparable results in terms of distribution of different regression grades. In univariate analysis regression gradings ( P = 0.003 and P = 0.007), yp T ‐stage, yp N ‐stage and status of resection margins ( P < 0.001) were significantly associated with the 5‐year overall survival ( OS ). None of the pretreatment clinicopathological parameters showed association with histopathological tumour regression. Multivariate analysis revealed the status of resection margins and of lymph node metastasis as statistically significant features for OS ( P = 0.020 and P = 0.003, respectively). Conclusion Tumour regression grading, nodal stage and status of resection margins predict prognosis in patients after neoadjuvant treatment. Currently, there are no pretreatment clinicopathological parameters, which predicting good tumour response to therapy. Thus, identifying non‐responding patients, which might benefit from an intensified systemic therapy, requires surgical resection and consecutive histopathological assessment. Therefore, further investigation and validation of new, especially, molecular predictors of tumour response to radiochemotherapy remains an unmet, future clinical need.