Janet R Williams*
Department of Radiation Oncology, The Prince of Wales Cancer Centre, Randwick, AustraliaFulltext PDF
Purpose: To evaluate whether radiotherapy can be substituted for surgery in the management of squamous cell carcinoma (SqCC) arising in the retromolar trigone (RMT) anatomical site. Materials and Methods: This ethics approved study evaluated patients diagnosed with a RMT SqCC and treated at the Prince of Wales Cancer Centre (POWCC) between 1974 and 2017, with minimum two-year follow-up. Analysis was performed using the Kaplan-Meier method and log-rank test to describe any time-to-event data. Objectives: Endpoints which were evaluated include local and ultimate local control, nodal and ultimate nodal control, cancer-specific and overall survival, and time to development of a second malignancy.
Results: There were 53 patients meeting all the eligibility criteria, with a definite smoking and alcohol consumption association. There were 16 (30%) patients having surgery as the only treatment and combined with radiotherapy in 16 (30%) patients, and 19 (36%) patients had radiotherapy alone, with two (4%) patients treated with chemotherapy only. Of the radiotherapy group, 8 (42%) patients failed locally. With surgical salvage, ultimate local control for this group was 69% at 5 years. Ultimate local control was 75% for patients treated initially with surgery alone, and 73% for combined treatment at 5 years (p=0.823). There is a high probability of developing another smoking related malignancy. Conclusions: Although surgical salvage can be considered, radiotherapy as the only treatment has an inferior outcome to surgery (± radiotherapy). Surgery remains the best way to address RMT SqCC where the patient is fit enough for the operation.
Head and Neck Cancer; Retromolar Trigone; Radiotherapy; Surgery; Survival
Robert I Smee, Janet R Williams, Damian P Kotevski. Surgery Remains the Treatment of Choice for Retromolar Trigone Carcinomas. Annal of Otol Head and Neck Surg. 2023;2(2):1-17.