HNSCC: posttreatment pathological complete remission is a key prognostic factor

  • Wang K & al.
  • Radiat Oncol
  • 12 Dec 2019

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Pathological complete remission (pCR) after preoperative radiotherapy/chemoradiotherapy (RT/CRT) is associated with improved survival outcomes among patients with locally advanced head and neck squamous cell carcinoma (LA-HNSCC).

Why this matters

  • Identification of prognostic factors can help guide patient management.

Key results

  • 34.7% of patients experienced pCR.
  • Compared with lack of pCR, pCR was associated with better:
    • Local control: 93.2% vs 67.7% (P=.007).
    • OS: 83.3% vs 39.7% (P=.0006).
    • PFS: 76.1% vs 44.0% (P=.003).
    • Distant metastasis-free survival: 90.4% vs 56.3% (P=.005).
  • pCR remained associated with improved local control (HR, 54.839; P=.002) and OS (HR, 11.71; P=.000) in multivariate analysis.

Study design

  • Included 72 patients with LA-HNSCC who did not initially respond to preoperative RT/CRT and subsequently underwent resection of the primary lesion with or without neck dissection.
  • Their data were analyzed for associations between pathological tumor response and prognosis.
  • Funding: National Key R&D Program of China.

Limitations

  • Small patient numbers.