Outcome and fewer indications for adjuvant therapy for patients with oral squamous cell carcinomas under standardized tumor board conditions.
OBJECTIVE
The aim of our study was to review the outcome of patients with oral squamous cell carcinoma (OSCC) treated according to the current diagnostic and treatment protocols ["Tumor Board Group" (TBG)] compared to patients diagnosed before the introduction of standardized and certified guidelines ["Conventional Group" (CG)]. We also analyzed the influence of prognostic factors on overall survival (OS), disease-free survival (DFS) and recurrence-free survival (RFS) rates.


METHODS
A total of 321 patients (TBG 95 patients and CG 226 patients) with histologically confirmed OSCC were included in our study. RFS, DFS and OS rates were analyzed by Kaplan-Meier estimates. Cox regression was performed for multivariate analysis of prognostic factors. Results were statistically significant with a p value of <0.05.


RESULTS
T, N, AJCC stage, age and therapy resulted to be independent risk factors for OS and DFS. We were not able to identify statistically significant prognostic factors for RFS apart from grading. 31.58% of patients from the TBG received postoperative adjuvant treatment compared to 74.78% within the CG. The OS rate was 79.63% at 30 months for patients from the TBG in comparison with 65.54% for patients from the CG.


CONCLUSIONS
The implementation of standardized guidelines including the establishment of the "Tumor Board Conference" results in a higher percentage of patients receiving surgery as only treatment and in better OS rates. To further support this positive trend, patients shall be followed longer and analyzed in future. T, N and M as well as AJCC stage were identified as most important prognostic factors for OS and DFS in our study.
Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany. a.groebe@uke.de.
Alexander
http://orcid.org/0000-0002-2822-2006
A
Gröbe
Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
Lena
L
Rybak
Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Gerhard
G
Schön
Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
Ralf
R
Smeets
Department of Radiation Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Silke
S
Tribius
Department of Internal Medicine II and Clinic (Oncology Center), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Philippe
P
Schafhausen
Department of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Till S
TS
Clauditz
Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
Henning
H
Hanken
Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
Max
M
Heiland
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000379:methods / Q000592:standards; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D009367:Neoplasm Staging; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
Adjuvant therapy; Oral squamous cell carcinoma (OSCC); Outcome; Prognosis