Induction chemotherapy response and recurrence rates in correlation with N0 or N+ stage in oral squamous cell cancer (OSCC)

Abstract

The authors compared N0 with N+ cases in neoadjuvant chemotherapy regression and recurrence. During a 12-year period, 180 consecutive oral squamous cell cancer patients were observed. Of these patients, 78 were N0 and 102 N+ stages. The drugs used were as follows: bleomycin, vincristine, methotrexate, and mitolactol. After three courses of chemotherapy, the regression (complete response (CR), partial response (PR), and no response (NR)) and side effect rate were determined. All patients were operated on and observed for the number and localization of recurrences during 3 year follow-up time. The N0 cases came from T2-3, while N+ was from T2-4a (AJCC 2002). The regression in the N0 group was CR 46%, PR 53%, and NR 1%; but in the N+ group, it was CR 12%, PR 72%, and NR 16%. The regression rate was significantly higher (p = 0.00025) for N0 group than N+ group. The regression rate for T3 N0 was significantly higher (p = 0.055) than for T3 N+ cases. In the N0 stage, the regression rate was significantly higher (p = 0.0174) for T2 than T3. In N+ stage, there was no significant difference (p = 0.183) for T2-4a. The side effects were slight. The recurrence rate for the N0 group was significantly lower (15%, p = 0.000069), while for N+ group, it was 59%. The dependence in the T3 cases was also significant (p = 0.009) in the 3-year tumor-free survival. The N stage seems a more important prognostic factor for chemotherapy response and recurrence rate than the T stage. Stage III can be divided into subgroups without metastasis (III.a) and with metastasis (III.b.), based on significant difference in regression and recurrence rate.

Histopathological assessment of tumour regression, nodal stage and status of resection margins determines prognosis in patients with oral squamous cell carcinoma treated with neoadjuvant radiochemotherapy

“…A study in neoadjuvantly treated oesophageal cancer also did not reveal an association of tumour regression with pretreatment cTN‐stage (Reynolds et al , ). In contrast, another investigation in OSCC showed a correlation of tumour response with N0 or N+ stage (Olasz et al , ). Herein, the investigators did not perform a histopathological tumour regression grading, but only clinical examination to determine tumour response.…”

miR-448 downregulates MPPED2 to promote cancer proliferation and inhibit apoptosis in oral squamous cell carcinoma

“…Despite advances in treatment and diagnostics, the incidence and mortality rates associated with OSCC are increasing (2). Metastasis and recurrence of OSCC are significant factors (3,4). As with other cancers, the accumulation of genetic and epigenetic changes is involved in the development and progression of OSCC (5).…”

Interval between Intra-Arterial Infusion Chemotherapy and Surgery for Locally Advanced Oral Squamous Cell Carcinoma: Impacts on Effectiveness of Chemotherapy and on Overall Survival

“…Despite recent advances in aggressive combined treatment regimens, for example, radical surgery, chemoradiation, neoadjuvant chemotherapy, and target therapy, the long-term survival of OSCC patients has not substantially improved and responses to different treatment modalities are still difficult to predict. However, high morbidity and mortality rates are expected in patients who present with an advanced stage of the disease, low Karnofsky status, or bad habits [19]. Despite advances in the diagnosis and therapeutic treatment of OSCC, the prognosis for advanced stages of the disease remains poor.…”