Interventions for the treatment of oral and oropharyngeal cancers: surgical treatment

Bessell, Alyson; Glenny, Anne‐Marie; Furness, Susan; Clarkson, Jan E; Oliver, Richard; Conway, David I.; Macluskey, Michaelina; Pavitt, Sue; Sloan, Philip; Worthington, Helen V

doi:10.1002/14651858.cd006205.pub2

Cited by 69 publications

(27 citation statements)

References 134 publications

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“…Similar to previous published studies the majority of the cases were diagnosed in advanced stages 83% of patients were stage III or IV at time of diagnosis [1,9,13,16]. …”

Section: Discussionsupporting

confidence: 86%

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Primary surgery versus chemoradiotherapy for advanced oropharyngeal cancers: A longitudinal population study

O’Connell

Seikaly

Murphy

et al. 2013

Journal of Otolaryngology - Head & Neck Surgery

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BackgroundTreatment for advanced stage oropharyngeal squamous cell carcinoma (OPSCC) includes combined chemoradiation therapy or surgery followed by radiation therapy alone or in combination with chemotherapy. The goal of this study was to utilize available evidence to examine survival outcome differences in patients with advanced stage OPSCC treated with these different modalities.MethodsPatients with advanced stage OPSCC were identified. Primary outcome measurements were disease specific and overall survival rates with differences examined via Kaplan-Meier and logistic regression analysis.Results344 patients were enrolled. 94 patients underwent triple modality therapy inclusive of surgery followed by adjuvant combined chemotherapy and radiation therapy (S-CRT). 131 had surgery and radiation therapy (S-RT), while 56 had chemoradiation (CRT) therapy as their primary treatment. A total of 63 patients had single modality radiation therapy and were excluded from analysis due to the large number of palliative patients.Kaplan-Meier overall survival analysis showed that therapy with S-CRT had the highest disease specific survival at five years (71.1%). This is contrasted against S-RT and CRT, with five year survival rates at 53.9%, and 48.6%, respectively.Cox regression showed that the comparison of S-CRT vs. S-RT, and CRT is associated with statistically significant increased hazard ratios of 1.974, and 2.785, indicating that both S-RT and CRT are associated with a reduced likelihood of survival at 5 years when compared to S-CRT.ConclusionsIn this population based cohort study S-CRT is associated with a 17–22% 5 year disease specific survival benefit compared to CRT or S-RT.

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“…Similar to previous published studies the majority of the cases were diagnosed in advanced stages 83% of patients were stage III or IV at time of diagnosis [1,9,13,16]. …”

Section: Discussionsupporting

confidence: 86%

“…A systematic review examining the best evidence of surgical treatments of OPSCC in the current literature showed an improved survival in patients treatment with multimodality treatment comprised of surgical resection followed by combined chemotherapy and radiotherapy (S-CT/RT) compared to S alone or S-RT [9]. …”

Section: Introductionmentioning

confidence: 99%

Primary surgery versus chemoradiotherapy for advanced oropharyngeal cancers: A longitudinal population study

O’Connell

Seikaly

Murphy

et al. 2013

Journal of Otolaryngology - Head & Neck Surgery

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“…Regional and distant metastases have a powerful influence in reducing overall survival rates [7]. Small oral and oropharyngeal cancers have a locally invasive phenotype and surgery can be curative if clear margins are achieved [8]. Oral and oro-pharyngeal cancers spread through lymphatic pathways to the cervical lymph nodes.…”

Section: Clinical Issuesmentioning

confidence: 99%

Head and Neck Sentinel Lymph Node Biopsy: Current State of the Art

Sloan

2009

Head and Neck Pathol

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Sentinel node biopsy is an alternative to elective neck dissection for the management of T1/T2 oral and oro-pharyngeal squamous cell carcinomas and is also finding application to head and neck cancer at other sites. The main clinical aim of sentinel node biopsy is to achieve better staging and there is now evidence that the procedure reduces morbidity. Reported detection rates for sentinel neck nodes are greater than 95% and there is also a negative predictive value of 95% for negative sentinel nodes. Current histopathological protocols have been developed for use in the research setting and are designed to identify all micrometastatic disease. However the use of step serial sectioning at 150 micron intervals with pan-cytokeratin immunohistochemistry is currently advised and appears to upstage nodes by approximately 20% over the initial single routine stained section. Adoption of the UICC/TNM definitions is recommended for future sentinel node studies, but further refinements and descriptions are required. The SENT trial has recruited over 300 cases from 10 European centres and a quality control study of the pathological material is in progress. At the first consensus meeting of the SENT pathology group there were excellent levels of agreement on the diagnosis of positive and negative nodes, and a number of potential pitfalls such as non-malignant inclusions and staining artefacts were identified.

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“…32 Second, a more recent pooled analysis of EORCT 22931 and RTOG 9501 has shown only ECS and microscopically involved margins to be significant in both trials. First, a recent Cochrane Database Systematic Review pointed out that although there is some evidence for the efficacy of chemoradiation therapy over radiation therapy alone after surgery, this has not been proved for specific sites such as the oral cavity since trials lump all head/neck sites together and that further subsite analysis needs to be undertaken.…”

Section: Neoadjuvant (Induction) Chemotherapymentioning

confidence: 98%

Indications for Adjuvant Chemotherapy and Radiation Therapy

Ord¹

2012

Current Therapy in Oral and Maxillofacial Surgery

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Interventions for the treatment of oral and oropharyngeal cancers: surgical treatment

Cited by 69 publications

References 134 publications

Primary surgery versus chemoradiotherapy for advanced oropharyngeal cancers: A longitudinal population study

Primary surgery versus chemoradiotherapy for advanced oropharyngeal cancers: A longitudinal population study

Head and Neck Sentinel Lymph Node Biopsy: Current State of the Art

Indications for Adjuvant Chemotherapy and Radiation Therapy

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