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Long-term survival in locally advanced oral cavity cancer: an analysis of patients treated with neoadjuvant cisplatin-based chemotherapy followed by surgery.

AbstractBACKGROUND:
Neoadjuvant chemotherapy has been reported to be extremely active in head and neck cancer but has failed to give a statistically significant improvement in survival.
METHODS:
From 1981 to 1994, 33 operable patients with locally advanced oral cavity cancer received cisplatin-based chemotherapy before surgery. Postoperative radiotherapy was performed in high-risk patients.
RESULTS:
The overall clinical and pathologic complete response rates to neoadjuvant chemotherapy were 48% and 30%, respectively. At a median follow-up of 7.0 years (range, 0.3-15.3+ years), the 5-year and 10-year overall survival rates were 54.5% and 39.5%, and the disease-specific median survival was 6.6 years for all patients (8.3 and 2.3 years for stages III and IV, respectively). The univariate analysis showed a positive relationship between survival and male sex (p = .05), pathologic (p = .02), and clinical (p = .03) complete response. The Cox proportional hazard regression model confirmed the independent prognostic value of the clinical response with a 4.67 (95% CI, 1.70-12.86) hazard ratio. A second primary tumor occurred in six patients (18%), with a median of occurrence of 9 years (range, 7-11 years).
CONCLUSIONS:
This study confirms the prolonged survival expectancy largely exceeding 5 years for selected patients with stage IV and for most with stage III locally advanced oral cavity cancer achieving a clinical and/or pathologic complete response to chemotherapy.
AuthorsEnzo Maria Ruggeri, Paolo Carlini, Camillo Francesco Pollera, Salvatore De Marco, Paolo Ruscito, Paola Pinnarò, Mario Nardi, Diana Giannarelli, Francesco Cognetti
JournalHead & neck (Head Neck) Vol. 27 Issue 6 Pg. 452-8 (Jun 2005) ISSN: 1043-3074 [Print] United States
PMID15880411 (Publication Type: Journal Article)
Copyright(c) 2005 Wiley Periodicals, Inc.
Chemical References
  • Bleomycin
  • Vincristine
  • Vinblastine
  • Doxorubicin
  • Cisplatin
  • Fluorouracil
  • Methotrexate
Topics
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Bleomycin (therapeutic use)
  • Carcinoma, Squamous Cell (drug therapy, pathology, surgery)
  • Cisplatin (therapeutic use)
  • Doxorubicin (therapeutic use)
  • Female
  • Fluorouracil (therapeutic use)
  • Humans
  • Male
  • Methotrexate (therapeutic use)
  • Middle Aged
  • Mouth Neoplasms (drug therapy, pathology, surgery)
  • Neoadjuvant Therapy
  • Neoplasm Staging
  • Sex Factors
  • Survival Analysis
  • Time Factors
  • Vinblastine (therapeutic use)
  • Vincristine (therapeutic use)

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