Improved survival with preoperative chemotherapy followed by resection uncompromised by tumor response for advanced squamous cell carcinoma of the Head and Neck

Loré, John M.; Diaz-Ordaz, Ernesto A.; Spaulding, Monica B.; Chary, Kandala; Kaufman, Sol; Lawrence, William T.; Hong, Frederick; Gerold, Thomas; Sundquist, Nan; Barrali, Robert A.

doi:10.1016/s0002-9610(99)80341-9

Cited by 17 publications

(10 citation statements)

References 7 publications

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“…These results suggest that ABCG2-expressing cells are resistant to NAC, thereby increasing the fraction of ABCG2-expressing cells so that ABCG2-expressing residual cancer cells would be relevant to the mechanism of local recurrence in NAC-treated OTSCC patients. Some studies have also shown that patients whose disease responded to NAC had better local control and survival than those who received ineffective NAC (48,51). In our study, however, the relationship between the histological response after NAC and local recurrence or CSC marker expression was unclear.…”

Section: Local Recurrence -------------------------------------------contrasting

confidence: 61%

Expression of the cancer stem cell markers CD44v6 and ABCG2 in tongue cancer: Effect of neoadjuvant chemotherapy on local recurrence

Yanamoto

Yamada

Takahashi

et al. 2014

International Journal of Oncology

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Abstract. The efficacy of neoadjuvant chemotherapy (NAC) is controversial, and no report supports NAC with a high evidence level. Recently, we showed that a deep surgical margin was resected very close to the tumor site in many NAC-treated oral squamous cell carcinoma patients, suggesting that NAC may lead to local recurrence and poor outcomes. The purpose of this study was to evaluate the effect of NAC on tumor local recurrence using cancer stem cell marker immunohistochemistry. We retrospectively analyzed 89 patients who underwent radical surgery for tongue cancer, and examined the effect of NAC on tumor local recurrence. Cancer stem cell marker (CD44v6 and ABCG2) expression was detected by immunohistochemistry. In our study, the local recurrence rate was 12.4%. CD44v6 and ABCG2 expression was significantly associated with regional lymph node metastasis, pattern of invasion, depth of invasion, perineural invasion and local recurrence, respectively. Tumor local recurrence was a significant independent predictive factor of the 5-year disease specific survival. CD44v6 or ABCG2 positivity in NAC-treated patients was significantly associated with tumor local recurrence. It was suggested that local recurrence in NAC-treated cases is associated with cancer stem-like cells. We propose that NAC leads to the selection and/or residue of more aggressive cancer stem-like cells.

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Section: Local Recurrence -------------------------------------------contrasting

confidence: 61%

Expression of the cancer stem cell markers CD44v6 and ABCG2 in tongue cancer: Effect of neoadjuvant chemotherapy on local recurrence

Yanamoto

Yamada

Takahashi

et al. 2014

International Journal of Oncology

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“…19,21 On the other hand, some studies have also shown that patients whose disease responded to NAC had a better survival rate over those who received non-effective NAC. 20,23 The efficacy of NAC is controversial, as described above, and there has been no report with a high evidence level supporting this. Accordingly, at present, the standard treatment of oral cancers is surgery alone, and radiotherapy or concomitant chemoradiotherapy after surgery is recommended for high-risk cases in which recurrence or metastasis is expected.…”

Section: 18mentioning

confidence: 99%

Clinicopathological risk factors for local recurrence in oral squamous cell carcinoma

Yanamoto

Yamada

Takahashi

et al. 2012

International Journal of Oral and Maxillofacial Surgery

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Abstract. Local recurrence of oral squamous cell carcinoma (OSCC) after primary surgery has been considered to be a poor prognostic entity in terms of survival rate. The purpose of this study is to evaluate the incidence of local recurrence and to identify significant risk factors for the local recurrence in OSCC. We retrospectively reviewed records for 187 patients who underwent radical surgery for OSCC. The local recurrence rate was 16.0% (30/187 patients) in this study. The survival rate of patients with local recurrence was 33.3%, which was significantly lower than that (94.3%) of patients without local recurrence. Pattern of invasion (POI), neoadjuvant chemotherapy (NAC), and the status of the surgical margin were identified as factors influencing local recurrence. In particular, NAC and the status of the surgical margin were independent risk factors by multivariate analysis. The deep margin was resected at a close site in many NAC-treated patients, suggesting that NAC may lead to local recurrence and poor outcomes. No efficacy of NAC was observed, suggesting that the standard treatment of oral cancers is surgery alone.3

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“…HICKS et al 4 succeeded in having no positive margins in tongue cancer specimen whereas SPIRO et al 22 and SESSIONS et al 18 reported of 13 and 22% of patients with positive margins, respectively, likewise in tongue cancer. A high radicality of the surgical measures seemed to be necessary even after induction chemotherapy as has been demonstrated by several other studies reporting of high initial response of chemotherapy followed by surgery 6,11,16 . WANEBO et al 26 noted the importance of surgical resection even following aggressive neoadjuvant chemoradiation protocols (paclitaxel and cisplatin, 45-72 Gy) in order to reach a higher local and regional tumor control.…”

Section: Discussionmentioning

confidence: 80%

Relevance of positive margins in case of adjuvant therapy of oral cancer

Kovács

2004

International Journal of Oral and Maxillofacial Surgery

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Improved survival with preoperative chemotherapy followed by resection uncompromised by tumor response for advanced squamous cell carcinoma of the Head and Neck

Cited by 17 publications

References 7 publications

Expression of the cancer stem cell markers CD44v6 and ABCG2 in tongue cancer: Effect of neoadjuvant chemotherapy on local recurrence

Expression of the cancer stem cell markers CD44v6 and ABCG2 in tongue cancer: Effect of neoadjuvant chemotherapy on local recurrence

Clinicopathological risk factors for local recurrence in oral squamous cell carcinoma

Relevance of positive margins in case of adjuvant therapy of oral cancer

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