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- W2897717111 abstract "Patients (pts) with adverse pathologic factors in resected oral cavity squamous cell carcinomas without the high-risk features of positive margins and extracapsular extension represent a heterogeneous INT risk group commonly treated with adjuvant radiation. We conducted a multi-institutional study to define the factors predictive of survival in INT pts and created a risk stratification strategy and compared the outcomes to high risk pts. An IRB approved collaborative database of patients with primary OCSCC stage I-IVb AJCC 7th edition) treated with primary surgical resection between 1/1/2005 and 1/1/2015 with or without adjuvant therapy was established from 6 academic medical centers. From a total sample size of 1282 patients, we identified 678 patients treated with primary surgical resection and adjuvant radiation (RT) (367 INT & 311 high risk). Cox proportional hazard models were developed to identify significant predictors of overall survival (OS) in the INT risk group. Bootstrap analysis of OS was used to establish Hazard Ratios (HR) for each predictor which were used to generate a prognostic score and stratify INT pts into 3 cohorts whose outcomes were compared to high risk pts. Among the 678 pts with a median follow up of living pts of 56.6 months, analysis of overall survival revealed 5 significant prognostic factors: age, ever smoking, perineural invasion (PNI), pT3/4 and ≥2 nodes positive. Hazard ratios were transformed creating a points system allowing the stratification of INT pts into 3 groups (INT1 0-1 points; INT2 1.5-2 points, and INT3 >=2.5 points) which were compared to HI risk pts. INT risk grouping was significantly predictive of disease recurrence and OS. 3-year disease recurrence rates were 17%, 24%, 35%, and 45% for INT1, INT2, and INT3 and high-risk pts respectively. Similarly, 3-year OS were rates were 89%, 72%, 58%, 49% for INT1, INT2, and INT3 and high-risk pts, respectively. INT risk resected OCSCC patients carry prognoses with significant variation and can be classified into 3 groups predictive of disease recurrence and overall survival. Independent validation of this prognostic score may facilitate identification of INT risk pts who may be most likely to benefit from intensification of adjuvant therapy.Abstract 39; TableRisk FactorHR (95% CI)PointsAge <50 50-70 >701.00 1.53 (0.86-2.74) 1.92 (1.01-3.63)0 0.5 1Smoking Ever1.54 (1.01-2.38)0.5PNI1.48 (1.04-2.11)0.5pT3/T41.57 (1.10-2.25)0.5≥2 nodes +1.94 (1.35-2.78)1 Open table in a new tab" @default.
- W2897717111 created "2018-10-26" @default.
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- W2897717111 date "2018-11-01" @default.
- W2897717111 modified "2023-09-27" @default.
- W2897717111 title "Improving Prognostic Classification in Intermediate Risk (INT) Oral Cavity Squamous Cell Carcinoma (OCSCC): A Multi-institutional Collaborative Study" @default.
- W2897717111 doi "https://doi.org/10.1016/j.ijrobp.2018.06.139" @default.
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