Adjuvant radiotherapy after curative surgery for oral cavity squamous cell carcinoma and treatment effect of timing and duration on outcome—A Taiwan Cancer Registry national database analysis

Yung-Jen Cheng, Mu-Hung Tsai, Chun Ju Chiang, Sen-Tien Tsai, Tsang Wu Liu, Pei Jen Lou, Chun Ta Liao, Jin Ching Lin, Joseph Tung Chieh Chang, Ming Hsui Tsai, Pen Yuan Chu, Yi Shing Leu, Kuo Yang Tsai, Shyuang Der Terng, Chih Yen Chien, Muh Hwa Yang, Sheng Po Hao, Chuan Cheng Wang, Ming Hsun Tsai, Helen H.W ChenChin Kuo, Yuan-Hua Wu

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Conduct an accurate risk assessment of resected oral cavity squamous cell carcinoma (OSCC) patients by accessing a nationwide systemic investigation is pivotal to improve treatment outcomes. In this article, we tried to determine the impact of different prognostic factors for OSCC patients who received adjuvant radiotherapy (RT) after curative surgery, using Taiwan's national cancer registry database (TCR). A nationwide, large population-based study was conducted using TCR with patients identified from 2007 to 2015. The study variables included age, gender, cancer subsites, stage, histology grade, margin and extra-nodal extension (ENE) status, treatment type, surgery to RT interval (ORI), total RT treatment time (RTT), and RT dose. Univariate and multivariate analysis were performed to identify predictors of the variables associated with overall survival (OS), cause-specific survival (CSS), local-regional relapse-free survival (LRFS), and distant metastasis-free survival (DMFS). 8986 OSCC patients treated with surgery and adjuvant RT were analyzed. In multivariate analysis, worse outcomes were associated with males, older age, subsite in the oral tongue, advanced stage, higher histologic grade, involved margin, and positive ENE. ORI only showed an adverse trend in LRFS, when exceeding 7 weeks (P =.06). RTT >8 weeks was a significant poor predictor in OS, CSS and LRFS (P <.001). Extreme RT dose (>70 Gy or ≤50 Gy) also demonstrated an adverse impact on the outcomes. Prolonged RT treatment time and extreme RT doses were identified as significantly poor prognostic predictors in OSCC patients who received adjuvant RT after curative surgery.

Original languageEnglish
Pages (from-to)3073-3083
Number of pages11
JournalCancer medicine
Volume7
Issue number7
DOIs
Publication statusPublished - 2018 Jul 1

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Adjuvant Radiotherapy
Taiwan
Registries
Mouth
Squamous Cell Carcinoma
Databases
Survival
Radiotherapy
Neoplasms
Therapeutics
Recurrence
Multivariate Analysis
Tongue
Histology
Neoplasm Metastasis

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Cheng, Yung-Jen ; Tsai, Mu-Hung ; Chiang, Chun Ju ; Tsai, Sen-Tien ; Liu, Tsang Wu ; Lou, Pei Jen ; Liao, Chun Ta ; Lin, Jin Ching ; Chang, Joseph Tung Chieh ; Tsai, Ming Hsui ; Chu, Pen Yuan ; Leu, Yi Shing ; Tsai, Kuo Yang ; Terng, Shyuang Der ; Chien, Chih Yen ; Yang, Muh Hwa ; Hao, Sheng Po ; Wang, Chuan Cheng ; Tsai, Ming Hsun ; Chen, Helen H.W ; Kuo, Chin ; Wu, Yuan-Hua. / Adjuvant radiotherapy after curative surgery for oral cavity squamous cell carcinoma and treatment effect of timing and duration on outcome—A Taiwan Cancer Registry national database analysis. In: Cancer medicine. 2018 ; Vol. 7, No. 7. pp. 3073-3083.
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title = "Adjuvant radiotherapy after curative surgery for oral cavity squamous cell carcinoma and treatment effect of timing and duration on outcome—A Taiwan Cancer Registry national database analysis",
abstract = "Conduct an accurate risk assessment of resected oral cavity squamous cell carcinoma (OSCC) patients by accessing a nationwide systemic investigation is pivotal to improve treatment outcomes. In this article, we tried to determine the impact of different prognostic factors for OSCC patients who received adjuvant radiotherapy (RT) after curative surgery, using Taiwan's national cancer registry database (TCR). A nationwide, large population-based study was conducted using TCR with patients identified from 2007 to 2015. The study variables included age, gender, cancer subsites, stage, histology grade, margin and extra-nodal extension (ENE) status, treatment type, surgery to RT interval (ORI), total RT treatment time (RTT), and RT dose. Univariate and multivariate analysis were performed to identify predictors of the variables associated with overall survival (OS), cause-specific survival (CSS), local-regional relapse-free survival (LRFS), and distant metastasis-free survival (DMFS). 8986 OSCC patients treated with surgery and adjuvant RT were analyzed. In multivariate analysis, worse outcomes were associated with males, older age, subsite in the oral tongue, advanced stage, higher histologic grade, involved margin, and positive ENE. ORI only showed an adverse trend in LRFS, when exceeding 7 weeks (P =.06). RTT >8 weeks was a significant poor predictor in OS, CSS and LRFS (P <.001). Extreme RT dose (>70 Gy or ≤50 Gy) also demonstrated an adverse impact on the outcomes. Prolonged RT treatment time and extreme RT doses were identified as significantly poor prognostic predictors in OSCC patients who received adjuvant RT after curative surgery.",
author = "Yung-Jen Cheng and Mu-Hung Tsai and Chiang, {Chun Ju} and Sen-Tien Tsai and Liu, {Tsang Wu} and Lou, {Pei Jen} and Liao, {Chun Ta} and Lin, {Jin Ching} and Chang, {Joseph Tung Chieh} and Tsai, {Ming Hsui} and Chu, {Pen Yuan} and Leu, {Yi Shing} and Tsai, {Kuo Yang} and Terng, {Shyuang Der} and Chien, {Chih Yen} and Yang, {Muh Hwa} and Hao, {Sheng Po} and Wang, {Chuan Cheng} and Tsai, {Ming Hsun} and Chen, {Helen H.W} and Chin Kuo and Yuan-Hua Wu",
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Cheng, Y-J, Tsai, M-H, Chiang, CJ, Tsai, S-T, Liu, TW, Lou, PJ, Liao, CT, Lin, JC, Chang, JTC, Tsai, MH, Chu, PY, Leu, YS, Tsai, KY, Terng, SD, Chien, CY, Yang, MH, Hao, SP, Wang, CC, Tsai, MH, Chen, HHW, Kuo, C & Wu, Y-H 2018, 'Adjuvant radiotherapy after curative surgery for oral cavity squamous cell carcinoma and treatment effect of timing and duration on outcome—A Taiwan Cancer Registry national database analysis', Cancer medicine, vol. 7, no. 7, pp. 3073-3083. https://doi.org/10.1002/cam4.1611

Adjuvant radiotherapy after curative surgery for oral cavity squamous cell carcinoma and treatment effect of timing and duration on outcome—A Taiwan Cancer Registry national database analysis. / Cheng, Yung-Jen; Tsai, Mu-Hung; Chiang, Chun Ju; Tsai, Sen-Tien; Liu, Tsang Wu; Lou, Pei Jen; Liao, Chun Ta; Lin, Jin Ching; Chang, Joseph Tung Chieh; Tsai, Ming Hsui; Chu, Pen Yuan; Leu, Yi Shing; Tsai, Kuo Yang; Terng, Shyuang Der; Chien, Chih Yen; Yang, Muh Hwa; Hao, Sheng Po; Wang, Chuan Cheng; Tsai, Ming Hsun; Chen, Helen H.W; Kuo, Chin; Wu, Yuan-Hua.

In: Cancer medicine, Vol. 7, No. 7, 01.07.2018, p. 3073-3083.

Research output: Contribution to journalArticle

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T1 - Adjuvant radiotherapy after curative surgery for oral cavity squamous cell carcinoma and treatment effect of timing and duration on outcome—A Taiwan Cancer Registry national database analysis

AU - Cheng, Yung-Jen

AU - Tsai, Mu-Hung

AU - Chiang, Chun Ju

AU - Tsai, Sen-Tien

AU - Liu, Tsang Wu

AU - Lou, Pei Jen

AU - Liao, Chun Ta

AU - Lin, Jin Ching

AU - Chang, Joseph Tung Chieh

AU - Tsai, Ming Hsui

AU - Chu, Pen Yuan

AU - Leu, Yi Shing

AU - Tsai, Kuo Yang

AU - Terng, Shyuang Der

AU - Chien, Chih Yen

AU - Yang, Muh Hwa

AU - Hao, Sheng Po

AU - Wang, Chuan Cheng

AU - Tsai, Ming Hsun

AU - Chen, Helen H.W

AU - Kuo, Chin

AU - Wu, Yuan-Hua

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Conduct an accurate risk assessment of resected oral cavity squamous cell carcinoma (OSCC) patients by accessing a nationwide systemic investigation is pivotal to improve treatment outcomes. In this article, we tried to determine the impact of different prognostic factors for OSCC patients who received adjuvant radiotherapy (RT) after curative surgery, using Taiwan's national cancer registry database (TCR). A nationwide, large population-based study was conducted using TCR with patients identified from 2007 to 2015. The study variables included age, gender, cancer subsites, stage, histology grade, margin and extra-nodal extension (ENE) status, treatment type, surgery to RT interval (ORI), total RT treatment time (RTT), and RT dose. Univariate and multivariate analysis were performed to identify predictors of the variables associated with overall survival (OS), cause-specific survival (CSS), local-regional relapse-free survival (LRFS), and distant metastasis-free survival (DMFS). 8986 OSCC patients treated with surgery and adjuvant RT were analyzed. In multivariate analysis, worse outcomes were associated with males, older age, subsite in the oral tongue, advanced stage, higher histologic grade, involved margin, and positive ENE. ORI only showed an adverse trend in LRFS, when exceeding 7 weeks (P =.06). RTT >8 weeks was a significant poor predictor in OS, CSS and LRFS (P <.001). Extreme RT dose (>70 Gy or ≤50 Gy) also demonstrated an adverse impact on the outcomes. Prolonged RT treatment time and extreme RT doses were identified as significantly poor prognostic predictors in OSCC patients who received adjuvant RT after curative surgery.

AB - Conduct an accurate risk assessment of resected oral cavity squamous cell carcinoma (OSCC) patients by accessing a nationwide systemic investigation is pivotal to improve treatment outcomes. In this article, we tried to determine the impact of different prognostic factors for OSCC patients who received adjuvant radiotherapy (RT) after curative surgery, using Taiwan's national cancer registry database (TCR). A nationwide, large population-based study was conducted using TCR with patients identified from 2007 to 2015. The study variables included age, gender, cancer subsites, stage, histology grade, margin and extra-nodal extension (ENE) status, treatment type, surgery to RT interval (ORI), total RT treatment time (RTT), and RT dose. Univariate and multivariate analysis were performed to identify predictors of the variables associated with overall survival (OS), cause-specific survival (CSS), local-regional relapse-free survival (LRFS), and distant metastasis-free survival (DMFS). 8986 OSCC patients treated with surgery and adjuvant RT were analyzed. In multivariate analysis, worse outcomes were associated with males, older age, subsite in the oral tongue, advanced stage, higher histologic grade, involved margin, and positive ENE. ORI only showed an adverse trend in LRFS, when exceeding 7 weeks (P =.06). RTT >8 weeks was a significant poor predictor in OS, CSS and LRFS (P <.001). Extreme RT dose (>70 Gy or ≤50 Gy) also demonstrated an adverse impact on the outcomes. Prolonged RT treatment time and extreme RT doses were identified as significantly poor prognostic predictors in OSCC patients who received adjuvant RT after curative surgery.

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