Prognostic role of preoperative neoadjuvant chemotherapy in patients with tongue cancer

Yıl 2023, , 106 - 111, 27.03.2023

Süleyman Cebeci , Emirhan Akyol , Utku Aydil Alper Dilci , Aytuğ Üner

https://doi.org/10.47582/jompac.1250138

Öz

Aim: This study aimed to investigate the relationship between preoperative neoadjuvant chemotherapy (NAC) and overall survival in patients with tongue cancer who underwent glossectomy.
Material and Method: The study included 35 tongue cancer patients who underwent glossectomy. Twenty patients did not receive any treatment before surgery (control group). Fifteen patients received two cycles of cisplatin-containing NAC prior to surgery. Five-year overall survival findings were compared between the groups.
Results: Median pathological depth of invasion was lower in the NAC group compared to the control group (7 vs. 9 mm, p=0.037). The mortality rate was lower in the NAC group (26.7% vs. 50.0%, p=0.008). Increased depth of invasion was independently associated with increased risk of mortality, while receiving NAC was independently associated with decreased risk of mortality. The risk of mortality was 6.25-fold lower (1/0.16) in the NAC group compared to the control group (HR: 0.16, 95% CI: 0.004-0.72, p=0.017).
Conclusion: Patients who underwent NAC plus surgery were associated with a higher probability of 5-year overall survival compared to patients who underwent surgery alone. These findings may be inspiring for the role of NAC prior to surgery in the prognosis of patients with tongue cancer.

Anahtar Kelimeler

Depth of invasion, neoadjuvant chemotherapy, prognosis, tongue cancer

Destekleyen Kurum

No

Dil kanserli hastalarda preoperatif neoadjuvan kemoterapinin prognostik rolü

Öz

Amaç: Bu çalışmanın amacı glossektomi uygulanan dil kanseri hastalarında preoperatif neoadjuvan kemoterapi (NAC) ile sağkalım arasındaki ilişkiyi araştırmaktı.
Gereç ve Yöntem: Çalışmaya dil kanseri nedeniyle glossektomi uygulanan 35 hasta dahil edildi. Yirmi hasta ameliyat öncesi herhangi bir tedavi almadı (kontrol grubu). On beş hasta ameliyattan önce iki kür sisplatin içeren NAC aldı. Beş yıllık sağkalım bulguları gruplar arasında karşılaştırıldı.
Bulgular: Medyan patolojik invazyon derinliği NAC grubunda kontrol grubuna göre daha düşüktü (7 vs 9 mm, p = 0.037). Mortalite oranı NAC grubunda daha düşüktü (%26.7 vs %50.0, p = 0.008). Artan invazyon derinliği, artan mortalite riskinin bağımsız belirteçleri olarak saptandı. Preoperatif NAC alımı ise azalan mortalite riskinin bağımsız bir belirteciydi. NAC grubunda mortalite riski kontrol grubuna göre 6,25 kat daha düşüktü (1/0,16) (HR: 0,16, %95 GA: 0,004-0,72, p = 0,017).
Sonuç: Preoperatif NAC sonrası cerrahi uygulanan hastalar, tek başına cerrahi uygulanan hastalara kıyasla 5 yıllık sağkalımda anlamlı bir iyileşme gösterdi. Bu bulgular, dil kanserli hastaların prognozunda ameliyattan önce NAC'nin rolü için ilham verici olabilir.

Anahtar Kelimeler

invazyon derinliği, neoadjuvan kemoterapi, nüks, prognoz, dil kanseri

Kaynakça

• Rusthoven KE, Raben D, Song JI, Kane M, Altoos TA, Chen C. Survival and patterns of relapse in patients with oral tongue cancer. J Oral Maxillofac Surg 2010; 68: 584-9.
• Liu SA, Wong YK, Wang CP, et al. Surgical site infection after preoperative neoadjuvant chemotherapy in patients with locally advanced oral squamous cell carcinoma. Head Neck 2011; 33: 954-8.
• Olasz L, Szalma J, Orsi E, Tornoczky T, Marko T, Nyarady Z. Neoadjuvant chemotherapy: does it have benefits for the surgeon in the treatment of advanced squamous cell cancer of the oral cavity? Pathol Oncol Res 2010; 16: 207-12.
• Hirakawa H, Hanai N, Suzuki H, et al. Prognostic importance of pathological response to neoadjuvant chemotherapy followed by definitive surgery in advanced oral squamous cell carcinoma. Jpn J Clin Oncol 2017; 47: 1038-46.
• Vishak S, Rangarajan B, Kekatpure VD. Neoadjuvant chemotherapy in oral cancers: Selecting the right patients. Indian J Med Paediatr Oncol 2015; 36: 148-53.
• Sturgis EM, Moore BA, Glisson BS, Kies MS, Shin DM, Byers RM. Neoadjuvant chemotherapy for squamous cell carcinoma of the oral tongue in young adults: a case series. Head Neck 2005; 27: 748-56.
• Pignon JP, Bourhis J, Domenge C, Designe L. Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. MACH-NC Collaborative Group. Meta-Analysis of Chemotherapy on Head and Neck Cancer. Lancet 2000; 355: 949-55.
• Pignon JP, le Maitre A, Maillard E, Bourhis J, Group M-NC. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol 2009; 92: 4-14.
• Posner MR, Hershock DM, Blajman CR, et al. Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. N Engl J Med 2007; 357: 1705-15.
• Vermorken JB, Remenar E, van Herpen C, et al. Cisplatin, fluorouracil, and docetaxel in unresectable head and neck cancer. N Engl J Med 2007; 357: 1695-704.
• Lorch JH, Goloubeva O, Haddad RI, et al. Induction chemotherapy with cisplatin and fluorouracil alone or in combination with docetaxel in locally advanced squamous-cell cancer of the head and neck: long-term results of the TAX 324 randomised phase 3 trial. Lancet Oncol 2011; 12: 153-9.
• Miyata H, Yoshioka A, Yamasaki M, et al. Tumor budding in tumor invasive front predicts prognosis and survival of patients with esophageal squamous cell carcinomas receiving neoadjuvant chemotherapy. Cancer 2009; 115: 3324-34.
• Patil VM, Noronha V, Joshi A, Banavali SD, Muddu V, Prabhash K. Preoperative Chemotherapy and Metronomic Scheduling of Chemotherapy in Locally Advanced Oral Cancers. Oncology 2016; 91 Suppl 1: 35-40.
• Kawashiri S, Noguchi N, Tanaka A, Nakaya H, Kato K, Yamamoto E. Inhibitory effect of neoadjuvant chemotherapy on metastasis of oral squamous cell carcinoma in a mouse model. Oral Oncol 2009; 45: 794-7.
• Stoecklein NH, Hosch SB, Bezler M, et al. Direct genetic analysis of single disseminated cancer cells for prediction of outcome and therapy selection in esophageal cancer. Cancer Cell 2008; 13: 441-53.
• Lahdesmaki H, Hao X, Sun B, et al. Distinguishing key biological pathways between primary breast cancers and their lymph node metastases by gene function-based clustering analysis. Int J Oncol 2004; 24: 1589-96.
• Faisal M, Abu Bakar M, Sarwar A, et al. Depth of invasion (DOI) as a predictor of cervical nodal metastasis and local recurrence in early stage squamous cell carcinoma of oral tongue (ESSCOT). PLoS One 2018; 13: e0202632.
• Aaboubout Y, van der Toom QM, de Ridder MAJ, et al. Is the Depth of Invasion a Marker for Elective Neck Dissection in Early Oral Squamous Cell Carcinoma? Front Oncol 2021; 11: 628320.
• Lydiatt WM, Patel SG, O’Sullivan B, et al. Head and Neck cancers-major changes in the American Joint Committee on cancer eighth edition cancer staging manual. CA Cancer J Clin 2017; 67: 122-37.
• Mair M, Raj L, Mahmood S, et al. Diagnostic accuracy of magnetic resonance imaging in detecting depth of invasion of tongue cancers. Br J Oral Maxillofac Surg 2021; 59: 1275-9.
• Mao MH, Wang S, Feng ZE, et al. Accuracy of magnetic resonance imaging in evaluating the depth of invasion of tongue cancer. A prospective cohort study. Oral Oncol 2019; 91: 79-84.
• Sungwalee W, Vatanasapt P, Suwanrungruang K, Promthet S. Comparing Survival of Oral Cancer Patients Before and After Launching of the Universal Coverage Scheme in Thailand. Asian Pac J Cancer Prev 2016; 17: 3541-4.
• Marta GN, Riera R, Bossi P, et al. Induction chemotherapy prior to surgery with or without postoperative radiotherapy for oral cavity cancer patients: Systematic review and meta-analysis. Eur J Cancer 2015; 51: 2596-603.
• Bossi P, Lo Vullo S, Guzzo M, et al. Preoperative chemotherapy in advanced resectable OCSCC: long-term results of a randomized phase III trial. Ann Oncol 2014; 25: 462-6.
• Beauvillain C, Mahe M, Bourdin S, et al. Final results of a randomized trial comparing chemotherapy plus radiotherapy with chemotherapy plus surgery plus radiotherapy in locally advanced resectable hypopharyngeal carcinomas. Laryngoscope 1997; 107: 648-53.
• Blanchard P, Bourhis J, Lacas B, et al. Taxane-cisplatin-fluorouracil as induction chemotherapy in locally advanced head and neck cancers: an individual patient data meta-analysis of the meta-analysis of chemotherapy in head and neck cancer group. J Clin Oncol 2013; 31: 2854-60.
• Chaukar D, Prabash K, Rane P, et al. Prospective Phase II Open-Label Randomized Controlled Trial to Compare Mandibular Preservation in Upfront Surgery With Neoadjuvant Chemotherapy Followed by Surgery in Operable Oral Cavity Cancer. J Clin Oncol 2022; 40: 272-81.