Post-operative radiotherapy in carcinoma of buccal mucosa, a prospective randomized trial

Mishra, R.C.; Singh, D.N.; Mishra, Tripurari

doi:10.1016/s0748-7983(96)92969-8

Cited by 71 publications

(36 citation statements)

References 11 publications

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“…Kokal et al [13] randomized 51 patients to surgery plus PORT vs surgery alone with accrual stopped after an interim analysis failed to reveal a benefit of PORT. The second randomized study demonstrated an improvement in disease free survival for PORT in HNSCC [28]. However, both studies have numerous weaknesses, limiting their relevance to contemporary medical practice, including small cohort size, non-contemporary imaging and RT techniques.…”

Section: Discussionmentioning

confidence: 99%

Lymph node ratio predicts the benefit of post-operative radiotherapy in oral cavity cancer

Urban¹,

Gluck²,

Pfeffer³

et al. 2013

Radiotherapy and Oncology

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Section: Discussionmentioning

confidence: 99%

Lymph node ratio predicts the benefit of post-operative radiotherapy in oral cavity cancer

Urban¹,

Gluck²,

Pfeffer³

et al. 2013

Radiotherapy and Oncology

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“…Cancer-specific survival was calculated using SEER*Stat software (version 6.2.4). All other data were analyzed using Stata software (version 8 Cox proportional hazards regression modeling was limited to covariates that we found to be statistically significant on univariate analysis. Due to missing data, a multivariate analysis was developed for the 4572 patients with complete datasets.…”

Section: Discussionmentioning

confidence: 99%

“…Although 2 small randomized trials suggested an improvement in locoregional control for combined surgery and RT compared with surgery alone, neither was adequately powered to demonstrate an overall survival advantage. 7,8 A matched pair analysis performed at the Mayo Clinic demonstrated improved neck control, causespecific survival, and overall survival for patients with stage III to IV head and neck cancer who were treated with combined surgery and RT compared with surgery alone. 9 Additional retrospective comparative series from the University of Texas M. D. Anderson Cancer Center, the University of Florida, and the Medical College of Virginia demonstrated significantly improved locoregional control with the addition of adjuvant RT to surgery.…”

mentioning

confidence: 99%

Adjuvant radiotherapy improves overall survival for patients with lymph node‐positive head and neck squamous cell carcinoma

Lavaf

Genden

Cesaretti

et al. 2007

Cancer

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BACKGROUND. Although adjuvant radiotherapy (RT) is often recommended for locally advanced squamous cell carcinoma of the head and neck (HNSCC), its effect on overall or cancer‐specific survival has not been clearly demonstrated. In the current study, the frequency and effect of adjuvant RT on overall survival was investigated in patients with resected lymph node‐positive head and neck cancer. METHODS. Within the Surveillance, Epidemiology, and End Results (SEER) database, patients were selected with lymph node‐positive HNSCC (American Joint Committee on Cancer and SEER stage 3/4) who were treated either with surgery alone or surgery and RT and were diagnosed between 1988 and 2001. A total of 8795 patients who met the inclusion criteria for analysis comprised the study population, with a median follow‐up of 4.3 years for patients still alive at the time of last follow‒up. RESULTS. Adjuvant RT was utilized in 84% of patients. Adjuvant RT improved the 5‐year overall survival (43.2% [95% confidence interval (95% CI), 41.9–44.4%] for surgery + RT vs 33.4% [95% CI, 30.7–36.0%] for surgery alone; P < .001) and cancer‐specific survival (50.9% for surgery + RT vs 42.1% for surgery) on univariate analysis. On multivariate analysis, adjuvant RT (hazards ratio [HR] of 0.78; 95% CI, 0.71–0.86 [P < .001]) remained a significant predictor of improved survival. The significant benefit of radiation on overall survival was noted for lymph node‐positive patients with both primary tumors localized to the involved organ (HR of 0.81; 95% CI, 0.71–0.94 [P = .007]) and more locally invasive primary tumors (HR of 0.77; 95% CI, 0.68–0.87 [P < .001]). CONCLUSIONS. In what to the authors' knowledge is the largest reported analysis of adjuvant RT in patients with locally advanced HNSCC published to date, adjuvant RT resulted in an approximately 10% absolute increase in 5‐year cancer‐specific survival and overall survival for patients with lymph node‐positive HNSCC compared with surgery alone. Despite combined surgery and adjuvant RT, outcomes in this high‐risk population remain suboptimal, emphasizing the need for continued investigation of innovative treatment approaches. Cancer 2008. © 2007 American Cancer Society.

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“…This conforms to the well-established observation in the literature that postoperative radiotherapy improves survival. 13,15,26 Mishra et al 27 reported on 140 locally advanced buccal cancers. Eighty patients treated with surgery plus postoperative radiotherapy were compared with 60 patients treated with surgery alone.…”

Section: Discussionmentioning

confidence: 99%

Squamous cell carcinoma of the buccal mucosa: An aggressive cancer requiring multimodality treatment

et al. 2006

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Background. In our clinical practice, we have observed a high incidence of locoregional failure in squamous cell carcinoma (SCC) of the buccal mucosa. We analyze our treatment results of this cancer and compare these results with those in the literature. We intend to define the pattern and incidence of failure of buccal cancer and provide information for the design of a better multimodality treatment.Methods. During the period from 1983 through 2003, 121 previously untreated patients with M0 stage SCC of the buccal mucosa were treated with a curative intent at our hospital. Twenty-seven patients received surgery alone, 36 had radiotherapy alone, and 58 underwent surgery plus postoperative radiotherapy.Results. The 5-year locoregional control, overall survival, and cause-specific survival rates for all patients were 36.3%, 34.3%, and 36.9%, respectively. The locoregional recurrence rate was 57% for all patients, with 80% occurring in the primary site alone. Patients with T1 -2N0 disease who received surgery alone still had a high local recurrence incidence of 41%. For patients with locally advanced disease, surgery plus postoperative radiotherapy achieved better overall survival and locoregional control rates than surgery alone or radiotherapy alone. T classification was the only prognostic factor affecting locoregional control and survival in the surgery alone group, whereas N classification and skin invasion predicted a poorer survival for the surgery plus postoperative radiotherapy group.Conclusions. SCC of the buccal mucosa is an aggressive cancer with a high locoregional failure rate even in patients with T1 -2N0 disease. Possible reasons include inadequate treatment and an intrinsically aggressive nature. Postoperative radiotherapy has resulted in a better locoregional control rate for patients with T3 -4 or N+ disease and should also be considered for patients with T1 -2N0 disease for whom adjuvant therapy after radical surgery currently is not recommended by most guidelines. A 2005 Wiley Periodicals, Inc. Head Neck 28: 150 -157, 2006

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Post-operative radiotherapy in carcinoma of buccal mucosa, a prospective randomized trial

Cited by 71 publications

References 11 publications

Lymph node ratio predicts the benefit of post-operative radiotherapy in oral cavity cancer

Lymph node ratio predicts the benefit of post-operative radiotherapy in oral cavity cancer

Adjuvant radiotherapy improves overall survival for patients with lymph node‐positive head and neck squamous cell carcinoma

Squamous cell carcinoma of the buccal mucosa: An aggressive cancer requiring multimodality treatment

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