title: The role of combined composite resection and irradiation in the management of carcinoma of the oral cavity and oropharynx.
abstract: Squamous cell carcinoma of the oral cavity and oropharynx can invade the mandible requiring an "en bloc" or composite resection. With this procedure alone, reported local control rates for advanced stage tumors have been suboptimal suggesting the need for adjuvant therapy. The treatment records of 35 patients were reviewed who were treated with composite resection alone, composite resection plus radiotherapy, or composite resection as a salvage procedure for a primary treatment failure. Combined irradiation and composite resection resulted in a higher local control than patients receiving composite resection alone (72% vs. 43%). There was no difference in complication rates between these two treatment groups. Composite resection as a salvage procedure resulted in local control in 38% of patients through this was associated with a 64% rate of complications. This data and a review of the literature suggest that tumors of the oral cavity and oropharynx with extension to the mandible requiring composite resection probably represent a category of tumors with a high risk of local recurrence and may benefit from adjuvant irradiation.
authors.affiliation: Department of Radiation Oncology, New England Medical Center Hospitals, Tufts University School of Medicine, Boston, Mass.
authors.forename: D E
authors.initials: DE
authors.lastname: Wazer
authors.forename: R
authors.initials: R
authors.lastname: Schmidt-Ullrich
authors.forename: M
authors.initials: M
authors.lastname: Keisch
authors.forename: C S
authors.initials: CS
authors.lastname: Karmody
authors.forename: W
authors.initials: W
authors.lastname: Koch
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery; D008339:Mandibular Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D010610:Pharyngeal Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D011879:Radiotherapy Dosage