2894 - Conditional Survival and Dynamic Failure Hazard of Oral Cavity Squamous Cell Carcinoma: Shedding Light on the Optimization of Treatment and Surveillance
Presenter(s)
N. Yu1, Y. Ma1, L. Li2, X. Guo3, S. Sun1, Y. Meng1, X. Huang3, Y. Zhang1, R. Wu1, K. Wang1, X. Chen1, Y. Qu1, J. Zhang1, L. Qingfeng4, J. Luo1, J. Xiao5, Y. X. Li6, J. Wang1, and J. YI1; 1Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China, 2Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China., Beijing, --- Select One ---, China, 3National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, --- Select One ---, China, 4Department of Radiation Oncology, Tianjin First Central Hospital, Tianjin, 300192, China., Tianjin, China, 5Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, China, 6National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Purpose/Objective(s): To provide a comprehensive analysis of conditional survival (CS) and dynamic failure hazards in oral cavity squamous cell carcinoma (OCSCC), enhancing prognostic understanding and facilitating more individualized treatment strategy and surveillance.
Materials/Methods: Patients with non-metastatic OCSCC undergoing surgery with or without postoperative radiation between 1999 and 2018 were retrospectively analyzed. Overall survival (OS), disease-free survival (DFS), conditional OS (COS), and conditional DFS (CDFS) were calculated. Annual hazards, including death, progression, and stage-specific risks, were estimated using Kernel-based methods.
Results: Among 700 patients (median follow-up: 97.6 months), 305 (43.6%) patients received postoperative radiotherapy. The 5-year overall survival (OS) and disease-free survival (DFS) rates were 68.3% and 62.0%, respectively. The 5-year COS improved from 68% after one year to 86% after five years, while the 5-year CDFS rose from 76% to 87%. Annual hazard rates for death and progression peaked in the first two years post-surgery, with death hazard declining from 9.8% to 3.3% and progression hazard decreasing from 20.0% to 2.9% by the fifth year. Stage-specific death hazards peaked at varying times: the second year for stages I/II, the third year for stage III, and the first two years for stage IV. Progression hazards peaked in the first year for all stages, with stage IV showing the highest risk at 32.0%, decreasing to ~4% by the fourth year.
Conclusion: This study provides an updated overview of CS and dynamic failure hazards in OCSCC, particularly emphasizing the high progression hazard in stage IV patients during the first year. These findings support tailored treatment strategies and rigorous early surveillance to improve outcomes.