Adjuvant radiotherapy is not supported in patients with verrucous carcinoma of the oral cavity

Mohan, Suresh; Pai, Sara I.; Bhattacharyya, Neil

doi:10.1002/lary.26443

Cited by 14 publications

(32 citation statements)

References 21 publications

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“…VC is a well-differentiated, indolent tumor, and unlike oral cavity SCC, is rarely associated with regional or distant metastases. [4][5][6][7][8] Surgical resection remains the primary treatment modality for oral cavity VC, and rates of PORT range from 10% to 18%. 9,10 However, the benefit of PORT is unclear, and may actually reduce survival.…”

Section: Introductionmentioning

confidence: 99%

“…In a recent cross-sectional population analysis of the Surveillance, Epidemiology, and End Results (SEER) database, Mohan et al reported that patients treated with PORT trended toward worse overall survival (OS) compared to those treated with surgery alone (71.4 and 117 months, respectively; P = .12). 5 There continues to be debate regarding the role of PORT in the management of oral cavity VC given its low metastatic potential, paucity of data surrounding outcomes after adjuvant treatment, and previous reports of anaplastic transformation following radiation therapy (RT). [11][12][13] Recent studies have disputed the concept of radiation-induced anaplastic transformation, and argue that such reports are reflective of tissue sampling errors.…”

Section: Introductionmentioning

confidence: 99%

“…[14][15][16] The radiosensitivity of VC is also controversial as adjuvant RT may not be as effective for these indolent tumors compared to conventional SCC. 5,9,17 Given the need for additional data regarding the use of adjuvant RT in the management of oral cavity VC, we present the current utilization of PORT and variables associated with its delivery in the United States. Secondarily, we report survival outcomes in this patient population, including the impact of PORT on OS, which supplements prior database studies.…”

Section: Introductionmentioning

confidence: 99%

“…Secondarily, we report survival outcomes in this patient population, including the impact of PORT on OS, which supplements prior database studies. 4,5,9…”

Section: Introductionmentioning

confidence: 99%

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Postoperative Radiation Therapy in Oral Cavity Verrucous Carcinoma

et al. 2022

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Objectives/Hypothesis We investigate the clinicopathologic and treatment factors associated with the use of postoperative radiation therapy (PORT) and its effect on overall survival (OS) for patients with oral cavity verrucous carcinoma (VC). Study Design Retrospective cohort study. Methods A retrospective cohort study of the National Cancer Database (NCDB) from 2006 to 2015 was performed. Multivariable logistic regression was used to identify independent predictive factors associated with the use of PORT. Cox Regression survival and propensity score analyses were used to evaluate the effect of PORT on mortality. Results A total of 356 adult patients with primary oral cavity VC who underwent definitive surgical resection were identified. A total of 10.7% of patients underwent definitive surgical resection followed by PORT. Variables associated with PORT included distance to the hospital per 10 miles (adjusted odds ratio [aOR], 0.81 [95% confidence interval (CI), 0.70–0.95]) and stage III–IV disease (aOR, 12.13 and 23.92, respectively). Multivariable Cox regression survival analysis indicated no evidence of survival benefit in patients undergoing PORT compared to surgery alone (adjusted hazard ratio 1.50 [0.74–3.05], P = .23). Propensity score analysis also showed no OS benefit with the use of PORT (P = .41). Conclusions Variables associated with the use of PORT on multivariable analysis included closer distance to hospital and stage III–IV disease. No clear survival benefit with PORT was identified on either multivariable survival analysis or propensity score analysis. These results suggest that surgery alone with negative margins may be the optimal treatment for patients with oral cavity VC. Level of Evidence 4 Laryngoscope, 132:1953–1961, 2022

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Secondarily, we report survival outcomes in this patient population, including the impact of PORT on OS, which supplements prior database studies. 4,5,9…”

Section: Introductionmentioning

confidence: 99%

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Postoperative Radiation Therapy in Oral Cavity Verrucous Carcinoma

et al. 2022

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“…[11] The study done by Mohan et al also reports that verrucous carcinoma which is treated with adjuvant radiotherapy has a worse overall survival and disease-specific survival as compared to both verrucous carcinoma treated with surgery alone and SCC treated with surgery and adjuvant radiotherapy. [12]…”

Section: Discussionmentioning

confidence: 99%

Case Report on Pinna: An Unusual Site for Verrucous Carcinoma

Khan

Akulwad

Sonone

2020

Indian Journal of Medical and Paediatric Oncology

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Verrucous carcinoma is an uncommon variant of well-differentiated squamous cell carcinoma and is frequently seen in the oral cavity and larynx having some relation with tobacco chewing, whereas, its presentation over the ear is a rare entity. Here, we report the case of a 70-year-old female patient with complaints of cauliflower-like mass over her left pinna which was managed by doing an excisional biopsy and diagnosed as verrucous carcinoma on histopathology.

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Elective Neck Dissection for cT1‐4 N0M0 Head and Neck Verrucous Carcinoma

Patel

Vedula

Haleem

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveTo investigate the survival benefit of elective neck dissection (END) over neck observation in cT1‐4 N0M0 head and neck verrucous carcinoma (HNVC).Study DesignRetrospective cohort study.SettingThe 2006 to 2017 National Cancer Database.MethodsPatients with surgically resected cT1‐4 N0M0 HNVC were selected. Linear, binary logistic, Kaplan‐Meier, and Cox proportional hazards regression models were utilized.ResultsOf 1015 patients satisfying inclusion criteria, 223 (22.0%) underwent END. The majority of patients were male (55.4%) and white (91.0%) with disease of the oral cavity (67.6%) classified as low grade (90.0%) and cT1‐2 (81.8%). The minority of ENDs (4.0%) detected occult nodal metastases. The rate of END increased from 2006 to 2017 for both cT1‐2 (16.3% vs 22.0%, p = .126, R2 = 0.405) and cT3‐4 (41.7% vs 70.0%, p = .424, R2 = 0.232) disease but these trends were not statistically significant. Independent predictors of undergoing END included treatment at an academic facility (adjusted odds ratio [aOR]: 1.75, 95% confidence interval [CI]: 1.19‐2.55), cT3‐4 disease (aOR: 3.31, 95% CI: 2.16‐5.07), and tumor diameter (aOR: 1.09, 95% CI: 1.01‐1.19) (p < 0.05). The 5‐year overall survival (OS) of patients treated with and without END was 71.3% and 70.6%, respectively (p = .661). END did not significantly reduce the 5‐year hazard of death (adjusted hazard ratio: 1.25, 95% CI: 0.91‐1.71, p = .172). END did not significantly improve 5‐year OS in univariate and multivariate analyses stratified by several patient, facility, tumor, and treatment characteristics.ConclusionEND does not confer an appreciable survival benefit in HNVC, even after stratifying univariate and multivariate analyses by several patient, facility, tumor, and treatment characteristics.Level of EvidenceLevel 4.

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Adjuvant radiotherapy is not supported in patients with verrucous carcinoma of the oral cavity

Abstract: 2C. Laryngoscope, 127:1334-1338, 2017.

Cited by 14 publications

References 21 publications

Postoperative Radiation Therapy in Oral Cavity Verrucous Carcinoma

Postoperative Radiation Therapy in Oral Cavity Verrucous Carcinoma

Case Report on Pinna: An Unusual Site for Verrucous Carcinoma

Elective Neck Dissection for cT1‐4 N0M0 Head and Neck Verrucous Carcinoma

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