Re-defining pT4b buccal mucosa squamous cell carcinoma: Looking beyond palliation in select patients
Objectives: Reports in the last 2 decades suggest that selected patients with masticator space invasion can be treated surgically with reasonable survival. This study is an attempt to identify prognosticators for disease free (DFS) and overall survival (OS) in surgically treated pT4 buccal mucosa sq...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-09-01
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| Series: | Oral Oncology Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S277290602400462X |
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| author | Prateek V. Jain Kapila Manikantan Gary M. Clark Indranil Mallick Sanjoy Chatterjee Indu Arun Paromita Roy Lateef Zameer Pattatheyil Arun |
| author_facet | Prateek V. Jain Kapila Manikantan Gary M. Clark Indranil Mallick Sanjoy Chatterjee Indu Arun Paromita Roy Lateef Zameer Pattatheyil Arun |
| author_sort | Prateek V. Jain |
| collection | DOAJ |
| description | Objectives: Reports in the last 2 decades suggest that selected patients with masticator space invasion can be treated surgically with reasonable survival. This study is an attempt to identify prognosticators for disease free (DFS) and overall survival (OS) in surgically treated pT4 buccal mucosa squamous cell carcinoma (BMSCC) patients. Material and methods: The cohort for this retrospective study comprised 213 patients with pT4a/b BMSCC, treated with curative intent surgery from August 2011 through December 2019. Depending upon masticator space invasion (MSI) patients were divided into 3 groups viz. pT4a, involvement of masseter and/or medial pterygoid (Low MSI) and involvement of lateral pterygoid and/or temporalis (High MSI). Results: The median follow-up in this study was 45 (2–123) months. The 5-year DFS was 53 %, 42 % and 21 % for pT4a, Low MSI and high MSI groups, respectively. The 5-year OS was 68 %, 43 % and 21 % for these three groups. The MSI (HR 1.5, p = 0.113 for Low MSI, HR 2.98, p < 0.001 for high MSI), perineural invasion (PNI) (HR 2.17, p = 0.001) and extranodal extension (ENE) (HR 2.74, p = 0.001) predicted poor DFS on multivariate analysis. OS was worse in patients with MSI (HR 1.86, p = 0.020 for Low MSI, HR 3.46, p < 0.001 for high MSI), PNI (HR 2.48, p < 0.001) and ENE (HR 3.02, p = 0.001) on multivariate analysis. Adjuvant treatment improved both OS and DFS. Conclusion: Select patients with masticator space involvement can benefit from aggressive treatment. Radiation with or without chemotherapy in adjuvant setting can further improve prognosis in these patients. |
| format | Article |
| id | doaj-art-19c7e1d907aa4605ba324257fbb64dca |
| institution | Kabale University |
| issn | 2772-9060 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Oral Oncology Reports |
| spelling | doaj-art-19c7e1d907aa4605ba324257fbb64dca2025-01-09T06:16:56ZengElsevierOral Oncology Reports2772-90602024-09-0111100616Re-defining pT4b buccal mucosa squamous cell carcinoma: Looking beyond palliation in select patientsPrateek V. Jain0Kapila Manikantan1Gary M. Clark2Indranil Mallick3Sanjoy Chatterjee4Indu Arun5Paromita Roy6Lateef Zameer7Pattatheyil Arun8Department of Head and Neck Surgery, Tata Medical Center, Kolkata, West Bengal, India; Corresponding author. Department of Head and Neck Surgery, Tata Medical Center, 14, Major Arterial Road (East- West), Newtown Action Area III, Kolkata, West Bengal, 700160, India.Department of Head and Neck Surgery, Tata Medical Center, Kolkata, West Bengal, IndiaGary Clark Statistical Consulting LLC, Superior, CO, United StatesDepartment of Radiation Oncology, Tata Medical Center, Kolkata, West Bengal, IndiaDepartment of Radiation Oncology, Tata Medical Center, Kolkata, West Bengal, IndiaDepartment of Pathology, tata medical Center, Kolkata, West Bengal, IndiaDepartment of Pathology, tata medical Center, Kolkata, West Bengal, IndiaDepartment of Pathology, tata medical Center, Kolkata, West Bengal, IndiaDepartment of Head and Neck Surgery, Tata Medical Center, Kolkata, West Bengal, IndiaObjectives: Reports in the last 2 decades suggest that selected patients with masticator space invasion can be treated surgically with reasonable survival. This study is an attempt to identify prognosticators for disease free (DFS) and overall survival (OS) in surgically treated pT4 buccal mucosa squamous cell carcinoma (BMSCC) patients. Material and methods: The cohort for this retrospective study comprised 213 patients with pT4a/b BMSCC, treated with curative intent surgery from August 2011 through December 2019. Depending upon masticator space invasion (MSI) patients were divided into 3 groups viz. pT4a, involvement of masseter and/or medial pterygoid (Low MSI) and involvement of lateral pterygoid and/or temporalis (High MSI). Results: The median follow-up in this study was 45 (2–123) months. The 5-year DFS was 53 %, 42 % and 21 % for pT4a, Low MSI and high MSI groups, respectively. The 5-year OS was 68 %, 43 % and 21 % for these three groups. The MSI (HR 1.5, p = 0.113 for Low MSI, HR 2.98, p < 0.001 for high MSI), perineural invasion (PNI) (HR 2.17, p = 0.001) and extranodal extension (ENE) (HR 2.74, p = 0.001) predicted poor DFS on multivariate analysis. OS was worse in patients with MSI (HR 1.86, p = 0.020 for Low MSI, HR 3.46, p < 0.001 for high MSI), PNI (HR 2.48, p < 0.001) and ENE (HR 3.02, p = 0.001) on multivariate analysis. Adjuvant treatment improved both OS and DFS. Conclusion: Select patients with masticator space involvement can benefit from aggressive treatment. Radiation with or without chemotherapy in adjuvant setting can further improve prognosis in these patients.http://www.sciencedirect.com/science/article/pii/S277290602400462XCarcinomaSquamous cellOral cancerSurvivalDisease-freeRadiation therapy |
| spellingShingle | Prateek V. Jain Kapila Manikantan Gary M. Clark Indranil Mallick Sanjoy Chatterjee Indu Arun Paromita Roy Lateef Zameer Pattatheyil Arun Re-defining pT4b buccal mucosa squamous cell carcinoma: Looking beyond palliation in select patients Oral Oncology Reports Carcinoma Squamous cell Oral cancer Survival Disease-free Radiation therapy |
| title | Re-defining pT4b buccal mucosa squamous cell carcinoma: Looking beyond palliation in select patients |
| title_full | Re-defining pT4b buccal mucosa squamous cell carcinoma: Looking beyond palliation in select patients |
| title_fullStr | Re-defining pT4b buccal mucosa squamous cell carcinoma: Looking beyond palliation in select patients |
| title_full_unstemmed | Re-defining pT4b buccal mucosa squamous cell carcinoma: Looking beyond palliation in select patients |
| title_short | Re-defining pT4b buccal mucosa squamous cell carcinoma: Looking beyond palliation in select patients |
| title_sort | re defining pt4b buccal mucosa squamous cell carcinoma looking beyond palliation in select patients |
| topic | Carcinoma Squamous cell Oral cancer Survival Disease-free Radiation therapy |
| url | http://www.sciencedirect.com/science/article/pii/S277290602400462X |
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