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Cheval M, Lopez R, Delanoë F, Vergez S, Dupret-Bories A, Lusque A, Chabrillac E. Oncological outcomes and prognostic factors of squamous cell carcinoma of the upper gingiva and hard palate: a retrospective study. Eur Arch Otorhinolaryngol 2023; 280:4569-4576. [PMID: 37233750 DOI: 10.1007/s00405-023-08033-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 05/17/2023] [Indexed: 05/27/2023]
Abstract
PURPOSE Despite sharing the same staging system as oral cavity cancers, upper gingiva and hard palate (UGHP) squamous cell carcinoma (SCC) have several features that make them a different entity. We aimed to analyze oncological outcomes and adverse prognostic factors of UGHP SCC, and assess an alternate T classification specific to UGHP SCC. METHODS Retrospective bicentric study including all patients treated by surgery for a UGHP SCC between 2006 and 2021. RESULTS We included 123 patients with a median age of 75 years. After a median follow-up of 45 months, the 5-year overall survival (OS), disease-free survival (DFS) and local control (LC) were 57.3%, 52.7% and 74.7%, respectively. Perineural invasion, tumor size, bone invasion, pT classification and pN classification were statistically associated with poorer OS, DFS and LC on univariate analysis. On multivariable analysis, the following variable were statistically associated with a poorer OS: past history of HN radiotherapy (p = 0.018), age > 70 years (p = 0.005), perineural invasions (p = 0.019) and bone invasion (p = 0.030). Median survivals after isolated local recurrence were 17.7 and 3 months in case of surgical and non-surgical treatment, respectively (p = 0.066). The alternate classification allowed better patient distribution among T-categories, however without improving prognostication. CONCLUSION There is a broad variety of clinical and pathological factors influencing prognosis of SCC of the UGHP. A comprehensive knowledge of their prognostic factors may pave the way towards a specific and more appropriate classification for these tumors.
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Affiliation(s)
- Marine Cheval
- Department of MaxilloFacial Surgery, Toulouse University Hospital - Pierre Paul Riquet Hospital, Toulouse, France
| | - Raphaël Lopez
- Department of MaxilloFacial Surgery, Toulouse University Hospital - Pierre Paul Riquet Hospital, Toulouse, France
| | - Franck Delanoë
- Department of MaxilloFacial Surgery, Toulouse University Hospital - Pierre Paul Riquet Hospital, Toulouse, France
| | - Sébastien Vergez
- Department of Surgery, University Cancer Institute of Toulouse - Oncopole, 1 Avenue Irène Joliot-Curie, 31100, Toulouse, France
- Department of Ear, Nose and Throat Surgery, Toulouse University Hospital - Larrey Hospital, Toulouse, France
| | - Agnès Dupret-Bories
- Department of Surgery, University Cancer Institute of Toulouse - Oncopole, 1 Avenue Irène Joliot-Curie, 31100, Toulouse, France
- Department of Ear, Nose and Throat Surgery, Toulouse University Hospital - Larrey Hospital, Toulouse, France
| | - Amélie Lusque
- Department of Biostatistics, Claudius Regaud Institute, University Cancer Institute of Toulouse - Oncopole, Toulouse, France
| | - Emilien Chabrillac
- Department of Surgery, University Cancer Institute of Toulouse - Oncopole, 1 Avenue Irène Joliot-Curie, 31100, Toulouse, France.
- Department of Ear, Nose and Throat Surgery, Toulouse University Hospital - Larrey Hospital, Toulouse, France.
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Rojas-Lechuga MJ, Gras-Cabrerizo JR, Aviles-Jurado FX, Malvehy J, Arance AM, Castillo P, Barreiro A, Podlipnik S, Lopez-Chacon M, Alobid I, Bernal-Sprekelsen M, Puig S, Langdon C. Sinonasal mucosal melanomas: defining profiles for better survival outcomes. Rhinology 2022; 60:347-356. [PMID: 36184882 DOI: 10.4193/rhin21.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Sinonasal mucosal melanoma is an aggressive malignancy with a 5-year survival rate ranging from 20% to 39%. Despite the evolving surgical and radiotherapy techniques, and introduction of immune-checkpoint inhibitor therapy, overall survival rates remain poor. METHODOLOGY A retrospective cohort study was conducted at the Hospital Clinic de Barcelona and the Hospital de la Santa Creu i Sant Pau between 1984 and 2020; primary outcome measures were 3 and 5-year melanoma-specific survival (MSS). Kaplan-Meier survival analysis and Cox proportional hazards model were performed to identify predictors of survival. RESULTS Fifty patients were included, the mean age was 70.4, MSS at 3 and 5 years was 51.2%, and 29.5%, respectively. The median follow-up was 39.6 months during which 46% presented locoregional recurrence and 36%, metastasis. The univariate and multivariate analyses found as survival predictors the N category, the treatment received, the surgical margins and the mitotic index. CONCLUSIONS We found an overall 5-year MSS of 29.5%. Those patients with intention-to-cure (stages III and IVa) treated by surgery that were N0 at diagnosis, with < 10 mitoses per HPF showed a 5-year MSS rate of 74.1%. More studies will be needed to adequately define the patients' profiles that will benefit from a better survival outcome.
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Affiliation(s)
- M J Rojas-Lechuga
- Otorhinolaryngology Department, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - J R Gras-Cabrerizo
- Otorhinolaryngology Head-Neck Surgery Department, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - F X Aviles-Jurado
- Otorhinolaryngology Department, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
- Head Neck Clínic, University and Research Grants Management Agency (AGAUR), 2017-SGR-01581
- and Center for Biomedical Research Network on Diabetes and Metabolic Diseases (CIBERDEM), Barcelona, Spain
| | - J Malvehy
- Melanoma Unit, Department of Dermatology, Hospital Clinic de Barcelona, IDIBAPS, Centre of Biomedical Research on Rare Diseases (CIBERER), ISCIII, Barcelona, Spain
| | - A M Arance
- Oncology Department, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
| | - P Castillo
- Pathology Department, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
| | - A Barreiro
- Melanoma Unit, Department of Dermatology, Hospital Clinic de Barcelona, IDIBAPS, Centre of Biomedical Research on Rare Diseases (CIBERER), ISCIII, Barcelona, Spain
| | - S Podlipnik
- Melanoma Unit, Department of Dermatology, Hospital Clinic de Barcelona, IDIBAPS, Centre of Biomedical Research on Rare Diseases (CIBERER), ISCIII, Barcelona, Spain
| | - M Lopez-Chacon
- Otorhinolaryngology Department, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - I Alobid
- Otorhinolaryngology Department, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - M Bernal-Sprekelsen
- Otorhinolaryngology Department, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - S Puig
- Melanoma Unit, Department of Dermatology, Hospital Clinic de Barcelona, IDIBAPS, Centre of Biomedical Research on Rare Diseases (CIBERER), ISCIII, Barcelona, Spain
| | - C Langdon
- Otorhinolaryngology Department, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
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