Surgical Resection is Justifiable for Oral T4b Squamous Cell Cancers With Masticator Space Invasion

Laryngoscope. 2021 Feb;131(2):E466-E472. doi: 10.1002/lary.28725. Epub 2020 May 27.

Abstract

Objectives: To examine survival endpoints in patients with tumor (T)4b oral cavity squamous cell carcinoma (OCSCC) with pathologically proven masticator space invasion treated with primary surgery followed by adjuvant therapy.

Study design: Retrospective review at an academic cancer center.

Methods: Twenty-five patients with T4b OCSCC with pathologic masticator space invasion were treated with primary surgery from May 2012 to December 2016. Only patients with ≥ 2 years follow-up from date of surgery were included. Sixteen patients received adjuvant chemoradiation.

Results: Median follow-up time was 39 months from date of surgery. Overall survival (OS), disease-specific survival (DSS), and recurrence-free survival at 24 months were 44.0%, 63.2%, and 52.6%, respectively. On univariate analyses, adjuvant chemoradiation was associated with improved OS. Advanced age and prolonged length of hospital stay was associated with worse OS.

Conclusion: For pT4b OCSCCA involving the masticator space, primary surgical resection followed by adjuvant chemoradiation demonstrates 24-month DSS of > 50% and OS of 44%.

Level of evidence: 4 Laryngoscope, 131:E466-E472, 2021.

Keywords: Oral cavity squamous cell carcinoma; T4b tumor; masticator space; oral cancer.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Masticatory Muscles / pathology*
  • Middle Aged
  • Mouth Neoplasms / mortality
  • Mouth Neoplasms / pathology
  • Mouth Neoplasms / surgery*
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Retrospective Studies
  • Survival Analysis