Significance of perineural invasion in locally advanced bucco alveolar complex carcinomas treated with surgery and postoperative radiation ± concurrent chemotherapy

Autor: Anil Kumar Anand, Abhishek Gulia, Harit Chaturvedi, Jyotika Jain, Biswajyoti Hazarika, Deepak Arora, Pankaj Agarwal, Vineeta Goel, Urmi Mukherjee, Anil Kumar Bansal
Rok vydání: 2016
Předmět:
Oncology
Adult
Male
medicine.medical_specialty
Multivariate analysis
medicine.medical_treatment
Perineural invasion
Disease
Kaplan-Meier Estimate
Risk Assessment
Disease-Free Survival
Cohort Studies
03 medical and health sciences
Young Adult
0302 clinical medicine
Internal medicine
medicine
Humans
Neoplasm Invasiveness
Risk factor
Tooth Socket
Survival analysis
Aged
Proportional Hazards Models
Retrospective Studies
Aged
80 and over
Analysis of Variance
business.industry
Proportional hazards model
Mouth Mucosa
Middle Aged
Prognosis
Combined Modality Therapy
Survival Analysis
Surgery
Radiation therapy
Cheek
Otorhinolaryngology
Chemotherapy
Adjuvant
030220 oncology & carcinogenesis
Multivariate Analysis
Carcinoma
Squamous Cell
Female
Mouth Neoplasms
Radiotherapy
Adjuvant
Radiotherapy
Intensity-Modulated
business
Adjuvant
030217 neurology & neurosurgery
Zdroj: Headneck. 39(7)
ISSN: 1097-0347
Popis: BACKGROUND The purpose of this study was to evaluate prognostic factors, locoregional control, and survival in locally advanced bucco-alveolar complex cancers. METHODS A retrospective review of 83 patients treated between January 2009 and December 2012 with bucco-alveolar complex cancers was conducted. All patients had surgery and adjuvant radiotherapy with intensity-modulated radiotherapy (IMRT) with/without concurrent chemotherapy. Survival analysis was performed using Kaplan-Meier and multivariable Cox regression model. RESULTS On univariate and multivariate analysis, perineural invasion (PNI) was found to be an independent adverse risk factor. Patients with PNI-positive disease had significantly worse 2-year disease-free survival (DFS), locoregional failure free survival, and overall survival (OS) as compared to patients with PNI-negative disease (P < 0. 001, 0.001 and < 0. 001) respectively. CONCLUSION Compared with patients with PNI-negative disease, patients with PNI-positive disease had much worse outcome despite aggressive adjuvant treatment. It warrants escalation of therapy and modification in radiation portals to cover neural pathways in patients with PNI-positive disease.
Databáze: OpenAIRE
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