背景:虽然手术仍然是口腔鳞状细胞癌(OCSCC)的主要治疗方法,诱导化疗(IC)可用作桥接或新辅助治疗。这项在台湾进行的全国性研究检查了手术前接受IC治疗的OCSCC患者的生存结果。
方法:我们分析了29,891例OCSCC患者的数据。其中,29,058人最初接受了手术(OP组),而833人在手术前接受了IC(IC+OP组)。倾向评分(PS)匹配分析(4,1比率,3260vs.815名患者)考虑肿瘤亚位点,性别,年龄,Charlson合并症指数,临床T1-T4b肿瘤,临床N0-3病,和临床I-IV期.
结果:在PS匹配队列中,5年疾病特异性生存率(DSS)和总生存率(OS)分别为65%和57%,分别。比较OP组和IC+OP组时,5年DSS率分别为66%和62%,分别(p=0.1162)。此外,5年OS率分别为57%和56%,分别(p=0.9917)。对于cT4a肿瘤的特定亚组,未观察到生存的显著组间差异,cT4b肿瘤,cN3病,pT4b肿瘤,pN3病然而,对于pT4a肿瘤患者,与IC+OP组相比,OP组表现出优于IC+OP组的5年结局,DSS为62%对52%(p=0.0006),OS为53%对44%(p=0.0060)。值得注意的是,在IC+OP组中,患有cT2-3,cN1和c-II期疾病的患者更有可能达到pT0-1状态(p<0.05).
结论:PS匹配后,IC+OP组的预后与OP组相似.然而,对于pT4a肿瘤,OP组的5年结局较好.虽然IC可能不会普遍提高生存率,对于对治疗有积极反应的患者可能是有利的。
BACKGROUND: While surgery remains the primary treatment for oral squamous cell carcinoma (OCSCC), induction chemotherapy (IC) can be used as a bridging or neoadjuvant therapy. This nationwide study in Taiwan examines the survival outcomes of OCSCC patients who received IC before surgery.
METHODS: We analyzed data from 29,891 patients with OCSCC. Of these, 29,058 initially underwent surgery (OP group), whereas 833 received IC before surgery (IC + OP group). A propensity score (PS)-matched analysis (4, 1 ratio, 3260 vs. 815 patients) was performed considering tumor subsite, sex, age, Charlson comorbidity index, clinical T1-T4b tumors, clinical N0-3 disease, and clinical stage I-IV.
RESULTS: In the PS-matched cohort, the 5-year disease-specific survival (DSS) and overall survival (OS) rates were 65% and 57%, respectively. When comparing the OP and IC + OP groups, the 5-year DSS rates were 66% and 62%, respectively (p = 0.1162). Additionally, the 5-year OS rates were 57% and 56%, respectively (p = 0.9917). No significant intergroup differences in survival were observed for specific subgroups with cT4a tumors, cT4b tumors, cN3 disease, pT4b tumors, and pN3 disease. However, for patients with pT4a tumors, the OP group demonstrated superior 5-year outcomes compared to the IC + OP group, with a DSS of 62% versus 52% (p = 0.0006) and an OS of 53% versus 44% (p = 0.0060). Notably, patients with cT2-3, cN1, and c-Stage II disease in the IC + OP group were significantly more likely to achieve pT0-1 status (p < 0.05).
CONCLUSIONS: Following PS matching, the IC + OP group generally exhibited similar prognosis to the OP group. However, for pT4a tumors, the OP group showed superior 5-year outcomes. While IC may not universally improve survival, it could be advantageous for patients who respond positively to the treatment.