title: T4b oral cavity cancer below the mandibular notch is resectable with a favorable outcome.
abstract: According to the AJCC 2002 staging system, squamous cell carcinoma of the oral cavity (OSCC) with T4b is unresectable. Herein, we report on our surgical outcome for T4b OSCC. All patients were enrolled before 2002. From January 1996 to December 2000, 45 consecutive untreated T4b OSCC patients were included. According to the trans-axial plane of the mandibular notch on CT/MRI, seven were supra-notch T4b and 38 were infra-notch T4b tumors. Significantly higher 5-year loco-regional control and survivals were observed in patients with infra-notch T4b than with supra-notch T4b. In the infra-notch group, pN0-1 patients had a significantly higher 5-year loco-regional control and survivals than pN2 patients. Nerve invasion was the sole significant adverse factor for loco-regional control and survivals in the infra-notch T4b group with pN0-1. Our retrospective study demonstrated that OSCC patients of infra-notch T4b with pN0-1 and no nerve invasion might have a favorable surgical outcome.
authors.affiliation: Departments of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Linkou, Taoyuan, Taiwan.
authors.forename: Chun-Ta
authors.initials: CT
authors.lastname: Liao
authors.forename: Shu-Hang
authors.initials: SH
authors.lastname: Ng
authors.forename: Joseph Tung-Chieh
authors.initials: JT
authors.lastname: Chang
authors.forename: Hung-Ming
authors.initials: HM
authors.lastname: Wang
authors.forename: Chuen
authors.initials: C
authors.lastname: Hsueh
authors.forename: Li-Yu
authors.initials: LY
authors.lastname: Lee
authors.forename: Chung-Kan
authors.initials: CK
authors.lastname: Tsao
authors.forename: Wen-Ho
authors.initials: WH
authors.lastname: Chen
authors.forename: I-How
authors.initials: IH
authors.lastname: Chen
authors.forename: Chung-Jan
authors.initials: CJ
authors.lastname: Kang
authors.forename: Shiang-Fu
authors.initials: SF
authors.lastname: Huang
authors.forename: Tzu-Chen
authors.initials: TC
authors.lastname: Yen
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008334:Mandible / Q000473:pathology*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D019647:Oral Surgical Procedures; D011878:Radiotherapy; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome