Adjuvant radiotherapy mitigates impact of perineural invasion on oncologic outcomes in early-stage oral cavity squamous cell carcinoma. A multi-institutional analysis of 557 patients

Holcomb, Andrew J.; Farrokhian, Nathan; Tolan, Claire; Whiteford, Erin; Villwock, Mark R.; Kakarala, Kiran; Shnayder, Yelizaveta; Sykes, Kevin J.; Lominska, Chris; Gan, Gregory N.; Buchakjian, Marisa R.; Harding, Brette C.; Dooley, Laura; Shinn, Justin R.; Wood, C. Burton; Rohde, Sarah L.; Zhan, Kevin Y.; Abt, Nicholas B.; Varvares, Mark A.; Bur, Andrés M.

doi:10.1016/j.oraloncology.2023.106420

Cited by 5 publications

(3 citation statements)

References 29 publications

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“…After title and abstract assessment, 133 studies were selected for full-text evaluation. According to the abovementioned inclusion and exclusion criteria, nine studies [20][21][22][23][24][25][26][27][28] were included for qualitative and quantitative analyses.…”

Section: Literature Search Results and Study Characteristicsmentioning

confidence: 99%

“…Interestingly, they both found that in this category of patients, PORT improves OS, although only the result from Nair et al 25 reached statistical significance (p = 0.02). Considering DFS, all three studies included in the pooled analysis singularly showed a survival benefit of PORT in PNI+ OSCC [26][27][28] . Of notice, all these three studies included only T1-T2 OSCC with PNI and without close or positive margins, increasing the relevance of our result.…”

Section: Discussionmentioning

confidence: 99%

“…Of notice, all these three studies included only T1-T2 OSCC with PNI and without close or positive margins, increasing the relevance of our result. Among studies included in the pooled analysis for LRC, only the one by Holcomb et al 27 included solely PNI + T1-2 OSCC with negative margins, and interestingly it found a significantly improved disease control in patients undergoing PORT.…”

Section: Discussionmentioning

confidence: 99%

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Impact of Adjuvant Radiotherapy in Squamous Cell Carcinoma of the Oral Cavity with Perineural Invasion

Festa,

Costantino,

Pace

et al. 2023

The Laryngoscope

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ObjectiveCurrent guidelines indicate postoperative radiotherapy (PORT) in oral squamous cell carcinoma (OSCC) with perineural invasion (PNI), however, its real benefit has never been proven. The aim of our study is to investigate the benefit of PORT in OSCC patients with PNI in terms of survival and disease control.Data SourcesThe Pubmed/MEDLINE, Cochrane Library, and Scopus databases.Review MethodsPatients with PNI + OSCC treated with primary surgery were extracted from the included studies. The pooled logHR was calculated by comparing patients who underwent PORT to those who underwent only observation for overall survival (OS), disease‐specific survival (DSS), disease‐free survival (DFS), and locoregional control (LRC).ResultsAbout 690 patients with primary OSCC and PNI were included from nine studies. 374 (54.2%) patients underwent PORT, while 316 (45.8%) underwent observation. Analyses showed non‐significant difference between the two groups for OS (HR: 1.01; 95% CI: 0.38–2.69), DSS (HR: 2.03; 95% CI: 0.54–7.56), and LRC (HR: 0.89; 95% CI: 0.53–1.50). They showed a significant difference in terms of DFS (HR: 0.86; 95% CI: 0.77–0.97).ConclusionThe real benefit of PORT in OSCC patients with PNI is still unclear, although it may have a positive impact on DFS. Clinicians should consider individual patient's characteristics, tumor factors, and treatment goals when deciding whether to recommend PORT. Further studies are needed to clarify which entity of PNI really benefits from PORT.Level of EvidenceN/A Laryngoscope, 2023

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