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Clinical Outcomes of Taiwanese Patients with cT4 Oral Cavity Squamous Cell Carcinoma: Toward the Identification of the Optimal Initial Treatment Approach for cT4b Patients

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机构： [1]Chang Gung Mem Hosp, Dept Otorhinolaryngol Head & Neck Surg, Taoyuan, Taiwan; [2]Chang Gung Univ, Taoyuan, Taiwan; [3]Chang Gung Univ, Clin Informat & Med Stat Res Ctr, Taoyuan, Taiwan; [4]Natl Hlth Res Inst, Natl Inst Canc Res, Zhunan Township, Miaoli County, Taiwan; [5]Natl Cheng Kung Univ, Natl Cheng Kung Univ Hosp, Dept Otolaryngol, Coll Med, Tainan, Taiwan; [6]China Med Hosp, Dept Otorhinolaryngol Head & Neck Surg, Taichung, Taiwan; [7]Taichung Vet Gen Hosp, Dept Radiat Oncol, Taichung, Taiwan; [8]Natl Taiwan Univ Hosp, Dept Otolaryngol, Coll Med, Taipei, Taiwan; [9]Taipei Vet Gen Hosp, Dept Otolaryngol, Taipei, Taiwan; [10]Mackay Mem Hosp, Dept Otolaryngol, Taipei, Taiwan; [11]Changhua Christian Hosp, Dept Oral & Maxillofacial Surg Head & Neck Surg, Changhua, Taiwan; [12]Sun Yat Sen Canc Ctr, Dept Head & Neck Surg, Koo Fdn, Taipei, Taiwan; [13]Taipei Med Univ, Shuang Ho Hosp, Dept Otolaryngol Head & Neck Surg, Taipei, Taiwan; [14]Chang Gung Mem Hosp, Div Hematol Oncol, Dept Internal Med, Keelung, Taiwan; [15]Chang Gung Univ, Dept Otolaryngol, Coll Med, Chang Gung Mem Hosp,Kaohsiung Med Ctr, Taoyuan, Taiwan; [16]Chang Gung Mem Hosp, Dept Radiat Oncol, Chiayi, Taiwan; [17]Chang Gung Mem Hosp, Dept Pathol, Taoyuan, Taiwan; [18]Chang Gung Mem Hosp, Dept Radiat Oncol, Taoyuan, Taiwan; [19]Chang Gung Mem Hosp, Dept Med Oncol, Taoyuan, Taiwan; [20]Chang Gung Mem Hosp, Dept Diagnost Radiol, Taoyuan, Taiwan; [21]Chang Gung Mem Hosp, Dept Plast & Reconstruct Surg, Taoyuan, Taiwan; [22]Chang Gung Mem Hosp, Clin Trial Ctr, Biostat & Informat Unit, Taoyuan, Taiwan; [23]Chang Gung Mem Hosp, Dept Nucl Med, Taoyuan, Taiwan; [24]Chang Gung Mem Hosp, Mol Imaging Ctr, Taoyuan, Taiwan

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The National Comprehensive Cancer Network guidelines recommend that patients with oral cavity squamous cell carcinoma (OSCC) and cT4b disease should be either included in clinical trials or treated with a nonsurgical approach. However, surgery may be feasible in selected patients with adequate safety margins. Using the nationwide Taiwanese Cancer Registry Database, we examined the prognosis of cT4b OSCC patients in relation to their treatment approach. Of the 18,910 patients with previously untreated first primary OSCC identified between 2004 and 2010, 492 (2.6 %) had cT4b tumors. Of them, 327 (66 %) received initial treatment with surgery, whereas 165 (34 %) were initially treated with a nonsurgical approach. Of the latter group, 78 patients subsequently underwent surgery. A 5-year disease-specific survival (DSS) >= 45 % was considered as a favorable outcome. Better 5-year DSS and overall survival (OS) rates were observed in cT4b patients initially treated with surgery (vs. nonsurgery; DSS, 51 vs. 38 %; OS, 43 vs. 27 %, respectively, p < 0.001). Of the participants initially treated with surgery, patients with cN0-2 disease had better 5-year survival rates (DSS: cN0, 59 %; cN1, 53 %; cN2, 46 %; OS: cN0, 49 %; cN1, 50 %; cN2, 37 %) than those with cN3 disease (DSS: 0 %; OS: 0 %). Among cT4b patients who initially received a nonsurgical treatment, subjects who subsequently underwent surgery showed better outcomes. Primary surgery is performed in approximately two-thirds of cT4b OSCC patients, with cN0-2 cases showing a good prognosis. Patients who initially received a nonsurgical approach can subsequently be treated with surgery and achieve favorable outcomes.

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出版当年[2017]版：

大类 | 2 区医学

小类 | 2 区外科 3 区肿瘤学

最新[2023]版：

大类 | 2 区

医学

小类 | 2 区外科 3 区肿瘤学

第一作者：

第一作者机构： [1]Chang Gung Mem Hosp, Dept Otorhinolaryngol Head & Neck Surg, Taoyuan, Taiwan; [2]Chang Gung Univ, Taoyuan, Taiwan;

通讯作者：

通讯机构： [1]Chang Gung Mem Hosp, Dept Otorhinolaryngol Head & Neck Surg, Taoyuan, Taiwan; [2]Chang Gung Univ, Taoyuan, Taiwan; [22]Chang Gung Mem Hosp, Clin Trial Ctr, Biostat & Informat Unit, Taoyuan, Taiwan;

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