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Management of Stage III Oral Cavity Squamous Cell Carcinoma in Light of the New Staging System: a Critical Review

  • HEAD AND NECK CANCERS (EY HANNA, SECTION EDITOR)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Oral squamous cell carcinoma (OSCC) patients have a poor prognosis, especially in advanced stages. AJCC/UICC staging system 8th edition (TNM8) included depth of invasion (DOI) as part of T staging and stage III has become a heterogeneous group of lesions, composed of patients with larger DOI and/or width. Additionally, stage III includes N1, regardless of the primary tumor width or DOI. The real prognostic value of each of these characteristics and the need for adjuvant treatment for stage III patients is not well established.

Recent Findings

TNM8 stratified OSCC into prognostic groups based on overall survival. Extranodal extension, positive or close margins, pT3 or pT4 tumors, pN2 or pN3 nodal disease, nodal disease in levels IV or V, perineural invasion, vascular invasion, and lymphatic invasion are the main adverse features for OSCC, and adjuvant treatment is largely recommended for these patients.

Summary

Stage III patients should be addressed with caution. So far, there is no significant evidence for recommending or excluding adjuvant treatment for stage III OSCC without adverse features. The authors largely recommend adjuvant radiotherapy for these cases, especially because pT3 without adverse features is rare. Further studies on this topic are necessary.

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Authors and Affiliations

  1. Head and Neck Surgery, Instituto Do Câncer Do Estado de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (Icesp, HCFMUSP), Av. Dr. Enéas de Carvalho Aguiar, 255, 8Th Floor, Room 8174, São Paulo, SP, CEP: 05403-000, Brazil

    Leandro Luongo Matos & Ana Kober Leite

  2. Surgical Clinic, Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, Brazil

    Leandro Luongo Matos & Ana Kober Leite

  3. Faculdade de Medicina da, Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255, 8Th Floor, Room 8174, São Paulo, SP, Brazil

    Yasmin Laryssa Moura Guimarães

  4. Head and Neck Surgery, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Av. Dr. Enéas de Carvalho Aguiar, 255, 8Th Floor, Room 8174, São Paulo, SP, Brazil

    Claudio Roberto Cernea

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Matos, L.L., Guimarães, Y.L.M., Leite, A.K. et al. Management of Stage III Oral Cavity Squamous Cell Carcinoma in Light of the New Staging System: a Critical Review. Curr Oncol Rep 25, 107–113 (2023). https://doi.org/10.1007/s11912-022-01353-6

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