Chun-Ta Liao1, Yu-Wen Wen2, Lan Yan Yang3, Shu Ru Lee2, Shu-Hang Ng4, Tsang-Wu Liu5, Sen-Tien Tsai6, Ming-Hsui Tsai7, Jin-Ching Lin8, Peir-Rong Chen9, Pei-Jen Lou10, Cheng Ping Wang10, Pen-Yuan Chu11, Tzer-Zen Hwang12, Yi-Shing Leu13, Kuo-Yang Tsai14, Shyuang-Der Terng15, Tsung-Ming Chen16, Cheng-Hsu Wang17, Chih-Yen Chien18, Wen-Cheng Chen19, Li-Yu Lee20, Chien-Yu Lin21, Hung-Ming Wang22, Chia-Hsun Hsieh22, Chung-Kan Tsao23, Tuan-Jen Fang1, Shiang-Fu Huang1, Chung-Jan Kang1, Kai-Ping Chang1, Tzu-Chen Yen24. 1. Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. 2. Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan. 3. Biostatistics and Informatics Unit, Clinical Trial Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. 4. Department of Diagnostic Radiology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. 5. National Institute of Cancer Research, National Health Research Institutes, Taiwan. 6. Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan. 7. Department of Otorhinolaryngology, Head and Neck Surgery, China Medical University Hospital, Taiwan. 8. Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung, Taiwan. 9. Department of Otolaryngology, Hualien Tzu Chi Hospital and Tzu Chi University, Hualien, Taiwan. 10. Department of Otolaryngology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan. 11. Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan. 12. Department of Otolaryngology, E-DA Hospital and I-Shou University, Kaohsiung, Taiwan. 13. Department of Otolaryngology, Mackay Memorial Hospital, Taipei, Taiwan. 14. Department of Oral and Maxillofacial Surgery, Head and Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan. 15. Department of Head and Neck Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan. 16. Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan. 17. Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan. 18. Department of Otolaryngology, Chang Gung Memorial Hospital - Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan. 19. Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan. 20. Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. 21. Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. 22. Department of Medical Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. 23. Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. 24. Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. Electronic address: yentc1110@gmail.com.
Abstract
OBJECTIVES: Although patients with buccal squamous cell carcinoma (SCC) usually show acceptable outcomes, local control and survival rates are generally lower than those observed for tongue SCC. This study was designed to compare the clinical outcomes of Taiwanese patients with these two common oral cavity malignancies. METHODS: Patients with first primary buccal or tongue SCC who were included in the Taiwanese Cancer Registry Database between 2004 and 2012 were eligible. The study sample consisted of 16,379 patients (7870 buccal SCC and 8509 tongue SCC) who received surgery with or without adjuvant therapy. The 5-year disease-specific survival (DSS) and overall survival (OS) rates served as the outcome measures. RESULTS: Compared with tongue SCC, patients with buccal SCC had a higher prevalence of males (95.7% vs. 86.4%, p<0.0001), pT4 disease (21.4% vs. 12.7%, p<0.0001), and p-Stage IV (30.4% vs. 24.8%, p<0.0001) but a lower frequency of pN2 disease (15.2% vs. 18.5%, p<0.0001). The 5-year DSS and OS rates of buccal SCC patients were slightly higher than those of tongue SCC (78% vs. 77%, p=0.0297; and 71% vs. 69%, p=0.0231, respectively). Multivariate analysis identified tumor site (tongue vs. buccal SCC), sex (male vs. female), age (≥65 vs. <65years), pT classification (T4/T3/T2 vs. T1), and pN classification (N3/N2/N1vs. N0) as independent prognostic factors in the entire study cohort. CONCLUSIONS: The survival advantage of buccal SCC over tongue SCC appears significant in large clinical samples, despite a higher prevalence of p-Stage IV disease in the former.
OBJECTIVES: Although patients with buccal squamous cell carcinoma (SCC) usually show acceptable outcomes, local control and survival rates are generally lower than those observed for tongue SCC. This study was designed to compare the clinical outcomes of Taiwanese patients with these two common oral cavity malignancies. METHODS:Patients with first primary buccal or tongue SCC who were included in the Taiwanese Cancer Registry Database between 2004 and 2012 were eligible. The study sample consisted of 16,379 patients (7870 buccal SCC and 8509 tongue SCC) who received surgery with or without adjuvant therapy. The 5-year disease-specific survival (DSS) and overall survival (OS) rates served as the outcome measures. RESULTS: Compared with tongue SCC, patients with buccal SCC had a higher prevalence of males (95.7% vs. 86.4%, p<0.0001), pT4 disease (21.4% vs. 12.7%, p<0.0001), and p-Stage IV (30.4% vs. 24.8%, p<0.0001) but a lower frequency of pN2 disease (15.2% vs. 18.5%, p<0.0001). The 5-year DSS and OS rates of buccal SCCpatients were slightly higher than those of tongue SCC (78% vs. 77%, p=0.0297; and 71% vs. 69%, p=0.0231, respectively). Multivariate analysis identified tumor site (tongue vs. buccal SCC), sex (male vs. female), age (≥65 vs. <65years), pT classification (T4/T3/T2 vs. T1), and pN classification (N3/N2/N1vs. N0) as independent prognostic factors in the entire study cohort. CONCLUSIONS: The survival advantage of buccal SCC over tongue SCC appears significant in large clinical samples, despite a higher prevalence of p-Stage IV disease in the former.