Surgical Resection is Justifiable for Oral T4b Squamous Cell Cancers With Masticator Space Invasion.
OBJECTIVES: To examine survival endpoints in patients with tumor (T)4b oral cavity squamous cell carcinoma (OCSCC) with pathologically proven masticator space invasion treated with primary surgery followed by adjuvant therapy. STUDY DESIGN: Retrospective review at an academic cancer center. METHODS: Twenty-five patients with T4b OCSCC with pathologic masticator space invasion were treated with primary surgery from May 2012 to December 2016. Only patients with ≥ 2 years follow-up from date of surgery were included. Sixteen patients received adjuvant chemoradiation. RESULTS: Median follow-up time was 39 months from date of surgery. Overall survival (OS), disease-specific survival (DSS), and recurrence-free survival at 24 months were 44.0%, 63.2%, and 52.6%, respectively. On univariate analyses, adjuvant chemoradiation was associated with improved OS. Advanced age and prolonged length of hospital stay was associated with worse OS. CONCLUSION: For pT4b OCSCCA involving the masticator space, primary surgical resection followed by adjuvant chemoradiation demonstrates 24-month DSS of > 50% and OS of 44%. LEVEL OF EVIDENCE: 4 Laryngoscope, 2020.
Baddour, HM; Ochsner, MC; Patel, MR; Switchenko, JM; Beitler, JJ; Magliocca, K; Baugnon, KL; Solares, CA; Steuer, CE; El-Deiry, MW
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