Article ; Online: Validation of the risk factors for primary control of early T-stage laryngeal, oropharyngeal, and hypopharyngeal squamous cell carcinoma by transoral surgery: a prospective observational study.
International journal of clinical oncology
2021 Volume 26, Issue 11, Page(s) 1995–2003
Abstract: ... of early T-stage head and neck cancer by transoral surgery (TOS): (1) tumor thickness > 7 mm on enhanced ...
Abstract | Background: We had previously identified the following risk factors for insufficient control of early T-stage head and neck cancer by transoral surgery (TOS): (1) tumor thickness > 7 mm on enhanced computed tomography (CT), and (2) poor differentiation in pathological examination. We subsequently used a different patient cohort to validate the usefulness of these factors in determining the need for adaptation of TOS. Study setting: A prospective observational study METHODS: Patients who received TOS as a definitive treatment between April 1, 2016 and September 30, 2020 were included. Primary control rates (by single TOS and TOS alone) in relation to the above-mentioned risk factors were calculated. Overall (O), recurrence-free (RF), and disease-free (DF) survival (S) outcomes were evaluated. A combination analysis based on the number of risk factors was also performed. Results: Patients with tumor thickness > 7 mm had a 2.88-fold [95% confidence interval (CI) 1.01-8.51] higher risk of incomplete primary resection by single TOS, while patients who showed poor differentiation on pathological assessments had a 13.14-fold (95% CI 3.66-47.14) higher risk of insufficient primary control by TOS alone. The 3 year OS, RFS, and DFS rates were 99%, 83%, and 63%, respectively. Patients with both risk factors had a 93.00-fold (95% CI 4.99-1732.00) higher risk of incomplete primary control by TOS alone. Conclusions: Among patients with early-stage laryngeal, oropharyngeal, and hypopharyngeal squamous cell carcinoma, primary control by TOS alone may not be achieved in patients with both risk factors, that is, tumor thickness > 7 mm as measured by enhanced CT and poor differentiation on pathological examination. |
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MeSH term(s) | Carcinoma, Squamous Cell/surgery ; Head and Neck Neoplasms ; Humans ; Neoplasm Recurrence, Local ; Oropharyngeal Neoplasms/surgery ; Risk Factors ; Squamous Cell Carcinoma of Head and Neck/surgery |
Language | English |
Publishing date | 2021-07-21 |
Publishing country | Japan |
Document type | Journal Article ; Observational Study |
ZDB-ID | 1400227-9 |
ISSN | 1437-7772 ; 1341-9625 |
ISSN (online) | 1437-7772 |
ISSN | 1341-9625 |
DOI | 10.1007/s10147-021-01992-y |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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