Treatment-related determinants of survival in early-stage (T1-2N0M0) oral cavity cancer: A population-based study

Head Neck. 2017 May;39(5):876-880. doi: 10.1002/hed.24679. Epub 2017 Feb 25.

Abstract

Background: National guidelines support both surgical and radiotherapy (RT) as initial treatment options for early-stage oral cavity squamous cell carcinoma (SCC). There remains limited data evaluating the survival outcomes of RT and the current practice patterns for these lesions.

Methods: We conducted a retrospective review of 8274 patients in the Surveillance, Epidemiology, and End Results (SEER) database from 1988 to 2008 with T1 to T2N0M0 oral cavity SCC. Primary outcomes were 5-year overall survival (OS) and disease-specific survival (DSS).

Results: Surgical therapy had significantly improved OS (140 months; p < .001) and DSS (217 months; p < .001) compared to surgery with adjuvant RT (104 and 163 months, respectively) and definitive RT (68 and 136 months, respectively). The use of radiation alone was associated with an increased T classification, hard palate, retromolar trigone primary site lesions, and advanced patient age.

Conclusion: Primary radiation without surgery continues to be used in a subset of early-stage oral cavity SCCs, in which it is associated with decreased OS and DSS. © 2017 Wiley Periodicals, Inc. Head Neck 39: 876-880, 2017.

Keywords: Epidemiology; Surveillance; T1; T2; and End Results (SEER); cancer; early; floor of mouth; hard palate; oral cavity; prognosis; radiation; squamous cell carcinoma; surgery; survival; tongue.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Mouth Neoplasms / mortality*
  • Mouth Neoplasms / pathology
  • Mouth Neoplasms / therapy*
  • Neoplasm Staging
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • SEER Program
  • Survival Rate
  • United States / epidemiology