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The role of adjuvant radiotherapy in locally advanced T4 mandible squamous cell carcinoma in the N0 patient: a single centre experience

Lookup NU author(s): Dr Chang Lee, Matthew Kennedy

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Abstract

© 2022 International Association of Oral and Maxillofacial SurgeonsIn locally advanced oral squamous cell carcinoma (OSCC), namely that showing invasion of the mandible, demonstrating no high-risk (e.g. extranodal extension, positive margin) or intermediate-risk histopathological features (e.g. perineural invasion, lymphovascular invasion), the additional benefit of postoperative radiotherapy (PORT) currently remains uncertain. A retrospective review covering the period between January 1, 2010 and December 31, 2019 was conducted to identify patients from a single UK centre with locally advanced invasive mandibular OSCC defined as pT4a, with no nodal or distant metastasis (N0 M0). The primary outcome was to determine the disease-free survival and overall survival rates in the surgery + PORT group, in comparison to the surgery only group. Twenty-eight eligible patients were identified, with 13 patients in the surgery + PORT group and 15 patients in the surgery only group. A single patient in the surgery + PORT group developed disease recurrence and subsequently died (1/13) (median follow-up 5.24 years, range 2.13–10.71 years). No patient in the surgery only group developed disease recurrence or died (0/15) (median follow-up 5.13 years, range 1.37–10.93 years). It may be reasonable to consider omitting PORT in pT4a pN0 M0 OSCC of the mandible in patients who demonstrate no high- or intermediate-risk histopathological features, following multidisciplinary team discussion.

Publication metadata

Author(s): Lee CW, Jenkins GW, Lee-Warder L, Kennedy M, Iqbal MS, Adams J

Publication type: Article

Publication status: Published

Journal: International Journal of Oral and Maxillofacial Surgery

Year: 2022

Volume: 51

Issue: 10

Pages: 1251-1256

Print publication date: 01/10/2022

Online publication date: 25/01/2022

Acceptance date: 10/01/2022

ISSN (print): 0901-5027

ISSN (electronic): 1399-0020

Publisher: Churchill Livingstone

URL: https://doi.org/10.1016/j.ijom.2022.01.003

DOI: 10.1016/j.ijom.2022.01.003

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