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. 2024 Aug;13(15):e70061.
doi: 10.1002/cam4.70061.

Prognostic impact of bridge or neoadjuvant induction chemotherapy in patients with resected oral cavity cancer: A nationwide cohort study

Cheng-Lung Hsu  1 , Yu-Wen Wen  2   3 , Hung-Ming Wang  1 , Chia-Hsun Hsieh  1 , Chi-Ting Liao  1 , Li-Yu Lee  4 , Shu-Hang Ng  5 , Chien-Yu Lin  6 , Wen-Cheng Chen  7 , Jin-Ching Lin  8 , Yao-Te Tsai  9 , Shu-Ru Lee  10 , Chih-Yen Chien  11 , Chun-Hung Hua  12 , Cheng Ping Wang  13 , Tsung-Ming Chen  14 , Shyuang-Der Terng  15 , Chi-Ying Tsai  16 , Kang-Hsing Fan  17 , Chih-Hua Yeh  5 , Chih-Hung Lin  18 , Chung-Kan Tsao  18 , Nai-Ming Cheng  19 , Tuan-Jen Fang  20 , Shiang-Fu Huang  20 , Chung-Jan Kang  20 , Li-Ang Lee  20 , Ku-Hao Fang  20 , Yu-Chien Wang  20 , Wan-Ni Lin  20 , Li-Jen Hsin  20 , Tzu-Chen Yen  19 , Chun-Ta Liao  20
Affiliations

Prognostic impact of bridge or neoadjuvant induction chemotherapy in patients with resected oral cavity cancer: A nationwide cohort study

Cheng-Lung Hsu et al. Cancer Med. 2024 Aug.

Abstract

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.

Keywords: cancer registry; clinical outcomes; induction chemotherapy; oral cavity squamous cell carcinoma.

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Conflict of interest statement

The authors declare that there are no conflicts of interest that could potentially influence the presentation or interpretation of the research findings in this study.

Figures

FIGURE 1
FIGURE 1
Patient progression through the study.
FIGURE 2
FIGURE 2
Kaplan–Meier plots comparing disease‐specific survival before (A, B) and after (C, D) propensity score matching in patients who initially underwent surgery (OP group) and those who received induction chemotherapy prior to surgery (IC + OP group).
FIGURE 3
FIGURE 3
Kaplan–Meier plots of disease‐specific survival and overall survival for patients with pT4a (A, B), pT4b (C, D), and pN3 (E, F) tumors in the propensity score‐matched cohort.
See this image and copyright information in PMC

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