title: Induction chemotherapy is associated with an increase in the incidence of locoregional recurrence in patients with carcinoma of the oral cavity: results from a single institution.
abstract: BACKGROUND
  This study was conducted to determine long term survival rates and the pattern of failure in patients with carcinoma of the oral cavity treated with induction chemotherapy or preoperative radiotherapy followed by surgery.
  
  
  METHODS
  A retrospective analysis was performed of 141 eligible patients with Stage II-IV International Union Against Cancer (UICC) staging system squamous cell carcinoma of the oral cavity at the study department between 1985 and 1994. These patients received one of three treatments: surgery with or without peplomycin chemotherapy (Group A; n = 49); preoperative radiotherapy with or without concomitant peplomycin chemotherapy followed by surgery (Group B; n = 59); and induction chemotherapy followed by surgery (Group C; n = 33). Induction chemotherapy was comprised of two cycles of cisplatin, vincristine, peplomycin, with or without mitomycin C.
  
  
  RESULTS
  When all 141 patients were analyzed, there was no significant difference in overall survival or disease free survival. However, a statistically significant increase in the incidence of neck recurrence in Group C was observed compared with Group A (P = 0.002). Within 79 patients with N0 disease, a statistically significant disadvantage was detected for Group C in terms of disease free survival compared with Group A (P = 0.038). In patients with Stage II disease (50 patients), there was a significant difference in disease free survival, with Group C inferior to both Group A (P = 0.04) and Group B (P = 0.066).
  
  
  CONCLUSIONS
  Induction chemotherapy was associated with a significant increase in regional failure for patients with carcinoma of the oral cavity with N0 disease and those with Stage II disease.
authors.affiliation: The First Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Osaka University, Suita-city, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Okura
authors.forename: T
authors.initials: T
authors.lastname: Hiranuma
authors.forename: T
authors.initials: T
authors.lastname: Adachi
authors.forename: T
authors.initials: T
authors.lastname: Ogura
authors.forename: T
authors.initials: T
authors.lastname: Aikawa
authors.forename: H
authors.initials: H
authors.lastname: Yoshioka
authors.forename: Y
authors.initials: Y
authors.lastname: Hayashido
authors.forename: M
authors.initials: M
authors.lastname: Kogo
authors.forename: T
authors.initials: T
authors.lastname: Matsuya
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009062:Mouth Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery; D009364:Neoplasm Recurrence, Local; D017663:Peplomycin / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D016019:Survival Analysis; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D000903:Antibiotics, Antineoplastic; D016685:Mitomycin; D017663:Peplomycin; D014750:Vincristine; D002945:Cisplatin