Background: To evaluate the clinicopathologic factors affecting the clinical outcomes in pathological T4aN0 (pT4aN0) buccal mucosal or gingival squamous cell carcinoma (SCC). Methods: This was a retrospective study of 113 consecutive patients with diagnoses of pT4aN0 buccal mucosal or gingival SCC between January 2010 and November 2018. The median follow-up was 38 months (range, 1–119 months). Kaplan-Meier and Cox proportional-hazards models were used for survival analysis. Results: In the entire study, 5-year overall survival (OS) and disease-free survival (DFS) rates were 73.7% and 83.6%, respectively. Univariate analysis revealed that lymphovascular invasion (LVI), perineural invasion (PNI), and margin status had significant effects on the DFS rate, and tumor cell differentiation had a significant effect on OS rate. Multivariate Cox regression analysis revealed margin status was the only significant factor affecting DFS. The patients (n=38) without the inadequate margin, LVI, PNI, and poorly differentiated tumor cells had a better 5-year DFS rate (P=0.023) whether they had received adjuvant treatment or not (91.5% versus 100%). However, no significant effect on the OS rate was found (P=0.544). Conclusions: The patients who had no adverse pathologic factors exhibited fair DFS rate without adjuvant therapy. The adjuvant therapy may not be considered for this subgroup.
Date:
2021-09-30
Relation:
Therapeutic Radiology and Oncology. 2021 Sep 30;5(3):Article number 6920.
