Surgical techniques and outcomes in patients with oral cavity cancer after induction chemotherapy

Abstract

Objective: Locally advanced Oral squamous cell carcinoma OSCC has a poor prognosis, surgery is mainline for treatment. The role of induction chemotherapy is still controversial. Methodology: This is a prospective study that included 25 patients with locally advanced OSCC who received induction chemotherapy with cisplatin, docetaxel & 5-FU (TPF) protocol regimen followed by surgical intervention. The epidemiological, surgical, and oncological outcomes of all the included patients were analyzed. Results: one patient showed no response, 18 patients had a partial response while 6 patients showed pathological complete response (pCR). Five out of the six patients who achieved pCR did not need reconstructive surgery and also five out of those 6 patients were operated on through a less destructive transoral approach. Consequently, those patients had less operative time, blood loss, hospital stay, and significantly less time to start oral feeding. The median disease-free survival was 15 (12-18) months in patients who attained pCR and 13 (5-24) months in the non pCR group. Conclusion: Pathological complete response after induction chemotherapy for locally advanced OSCC is associated with improvement in disease-free survival, less destructive surgery, and less need for flap reconstruction.