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Oral SCC patients with close margins may not need adjuvant therapy
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Researchers reported a 5-year local control rate of more than 90% in a cohort of patients with oral squamous cell carcinoma who underwent surgery but did not receive adjuvant chemotherapy.
Different institutions have different protocols for postoperative adjuvant therapy to treat adverse features in patients with oral squamous cell carcinoma. This particular group of researchers did not recommend adjuvant therapy on the basis of close margins — which they defined as <5 mm but uninvolved — unless additional adverse features were present.
Local control served as the primary endpoint, and disease-specific survival served as the secondary endpoint.
The analysis included 79 men and 65 women (median age, 64.1 years). The mean follow-up duration was 3.3 years.
Eligible participants underwent surgery with curative intent for oral squamous cell disease. They then were recorded as having close tumor margins on histology.
Five-year results indicated that, among patients who underwent surgery alone, the local control rate was 91% (95% CI, 81.9-95.2) and the disease-specific survival rate was 84% (95% CI, 74-89.9).
Patients with zero additional adverse features had a 5-year local control rate of 100%. Local control rates at 5 years were 96% for one additional adverse feature, 83% for two and 71% for three (P=.004; trend test).
Researchers observed no pattern of poorer local control or disease-specific survival with the ordered stratification of close margins.
“Surgery alone without postoperative adjuvant therapy offered acceptable local control in patients who had close margin status as their only adverse feature and may be reasonable in the presence of [one] other adverse clinicopathologic feature,” the researchers concluded.
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