Corbin D Jacobs1, Hannah Williamson2, Ian Barak2, Daniel J Rocke3, Russel R Kahmke3, Gita Suneja1, Yvonne M Mowery1. 1. Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina, USA. 2. Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina, USA. 3. Department of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, Durham, North Carolina, USA.
Abstract
BACKGROUND: Alveolar ridge squamous cell carcinoma (ARSCC) is poorly represented in randomized trials. METHODS: Adults in the National Cancer Database diagnosed with ARSCC between 2010 and 2014 who should be considered for postoperative radiotherapy (PORT) based on National Comprehensive Cancer Network (NCCN)-defined risk factors were identified. RESULTS: Eight hundred forty-five (58%) of 1457 patients meeting the inclusion criteria received PORT. PORT was associated with improved overall survival (OS) on unadjusted (hazard ratio [HR] 0.83, 95% confidence interval [CI] 0.70-0.98, P = .02) and multivariable (HR 0.78, 95% CI 0.64-0.94, P = .002) analyses. PORT was associated with significantly improved 5-year OS for patients with 1 (68% vs 58%, P < .001), 2 (52% vs 31%, P < .001), and ≥3 (38% vs 24%, P < .001) NCCN-defined risk factors. Prognostic variables significantly associated with worse OS on multivariable analysis included advanced age, primary tumor size ≥3 cm, high grade, positive margin(s), stage N2-3, level IV/V nodal metastasis, and extranodal extension. CONCLUSION: PORT for resected ARSCC with adverse pathologic features is associated with significantly improved OS.
BACKGROUND: Alveolar ridge squamous cell carcinoma (ARSCC) is poorly represented in randomized trials. METHODS: Adults in the National Cancer Database diagnosed with ARSCC between 2010 and 2014 who should be considered for postoperative radiotherapy (PORT) based on National Comprehensive Cancer Network (NCCN)-defined risk factors were identified. RESULTS: Eight hundred forty-five (58%) of 1457 patients meeting the inclusion criteria received PORT. PORT was associated with improved overall survival (OS) on unadjusted (hazard ratio [HR] 0.83, 95% confidence interval [CI] 0.70-0.98, P = .02) and multivariable (HR 0.78, 95% CI 0.64-0.94, P = .002) analyses. PORT was associated with significantly improved 5-year OS for patients with 1 (68% vs 58%, P < .001), 2 (52% vs 31%, P < .001), and ≥3 (38% vs 24%, P < .001) NCCN-defined risk factors. Prognostic variables significantly associated with worse OS on multivariable analysis included advanced age, primary tumor size ≥3 cm, high grade, positive margin(s), stage N2-3, level IV/V nodal metastasis, and extranodal extension. CONCLUSION: PORT for resected ARSCC with adverse pathologic features is associated with significantly improved OS.
Authors: Jay S Cooper; Thomas F Pajak; Arlene A Forastiere; John Jacobs; Bruce H Campbell; Scott B Saxman; Julie A Kish; Harold E Kim; Anthony J Cmelak; Marvin Rotman; Mitchell Machtay; John F Ensley; K S Clifford Chao; Christopher J Schultz; Nancy Lee; Karen K Fu Journal: N Engl J Med Date: 2004-05-06 Impact factor: 91.245
Authors: J M Bachaud; E Cohen-Jonathan; C Alzieu; J M David; E Serrano; N Daly-Schveitzer Journal: Int J Radiat Oncol Biol Phys Date: 1996-12-01 Impact factor: 7.038
Authors: B S M S Siriwardena; I K Rambukewela; T N Pitakotuwage; M N G P K Udagama; P V R Kumarasiri; W M Tilakaratne Journal: Biomed Res Int Date: 2018-05-13 Impact factor: 3.411