The role of adjuvant treatment in early‐stage oral cavity squamous cell carcinoma: An international collaborative study

Abstract

Patients with stage I to II OCSCC and positive/close margins have poor long-term outcomes. For this population, adjuvant treatment may be associated with improved survival. Cancer 2018;124:2948-55. © 2018 American Cancer Society.

Reply to Patients with revised surgical resection margins are best studied as a distinct group

“…Although the rate of re‐excision due to initial close resection margins (1‐4 mm) in the specimen‐driven resection margin arm was 29% (21 of 71 resection margins), in the patient‐driven resection margin arm, only 10% of cases (2 of 20 resection margins) required re‐excision. This former rate is not negligible and the concern of Sperry et al regarding our recent article raises 2 important questions: 1) does re‐excision introduce a risk factor regarding outcome? ; and 2) does this subgroup necessitate escalation of treatment?…”

Are adjuvant radiotherapy outcomes really better in patients with early‐stage oral cavity squamous cell carcinoma?

“…We read with interest the article by Fridman et al in a recent issue of Cancer. 1 We appreciate the efforts taken by the authors, and believe that such work will help us to understand treatment dynamics better.…”

“…It was interesting to note that, in their study, a total of 22.6% of patients (284 of 1255 patients) were treated with postoperative radiotherapy (PORT). 1 The authors did not provide any of the pertinent criteria used to arrive at this decision. Considering the fact that all patients were clinically and pathologically classified as N0 disease, we are inclined to believe that primary histopathological features could have led to this decision.…”

“…The authors reported that 16.6% of patients demonstrated close margins and 2.7% demonstrated positive margins. 1 Therefore, we tend to assume that this group of patients would have been candidates for RT.…”

“…The study by Fridman et al also reported that the 5-year overall survival rate was 52% for patients with close margins and 63% for patients with positive margins (P<.0001). 1 Patients with positive margins have a higher risk of locoregional failure. The finding that patients with positive margins were faring better can be misleading because the number of patients with positive margins in the study was very few at 2.7%.…”