Research Paper | Head and Neck Oncology|Articles in Press

Comparison of survival between palliative surgery and no surgery for advanced tongue squamous cell carcinoma: an analysis of SEER data

  • Author Footnotes
    1 Z. Ye, G. Tan, and L. Wang are co-first authors.
    Z. Ye
    Footnotes
    1 Z. Ye, G. Tan, and L. Wang are co-first authors.
    Affiliations
    Department of Maxillofacial Surgery, The People’s Hospital of Pingyang (Pingyang Hospital of Wenzhou Medical University), Wenzhou, Zhejiang, PR China
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  • Author Footnotes
    1 Z. Ye, G. Tan, and L. Wang are co-first authors.
    G. Tan
    Footnotes
    1 Z. Ye, G. Tan, and L. Wang are co-first authors.
    Affiliations
    Advanced Neuroimaging Laboratory, Department of Radiology, The Affiliated Yuebei People’s Hospital of Shantou University Medical College, Shaoguan, Guangdong, China
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  • Author Footnotes
    1 Z. Ye, G. Tan, and L. Wang are co-first authors.
    L. Wang
    Footnotes
    1 Z. Ye, G. Tan, and L. Wang are co-first authors.
    Affiliations
    School and Hospital of Stomatology, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine and Optional Institutions, Guangzhou Medical University, Guangzhou, Guangdong, PR China
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  • G. Shangguan
    Affiliations
    Department of Maxillofacial Surgery, The People’s Hospital of Pingyang (Pingyang Hospital of Wenzhou Medical University), Wenzhou, Zhejiang, PR China
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  • H. Yao
    Affiliations
    Department of Maxillofacial Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, PR China
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  • X. Xu
    Affiliations
    Department of Maxillofacial Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, PR China
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  • H. Ye
    Affiliations
    Institute of Digitized Medicine and Intelligent Technology, Wenzhou Medical University, Wenzhou, Zhejiang, PR China
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  • X. Ding
    Correspondence
    Correspondence to: Department of Maxillofacial Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, Zhejiang, PR China.
    Affiliations
    Department of Maxillofacial Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, PR China
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  • Author Footnotes
    1 Z. Ye, G. Tan, and L. Wang are co-first authors.

Abstract

The aim of this study was to investigate the survival effect of palliative surgery in advanced tongue squamous cell carcinoma (TSCC). A retrospective analysis of data in the SEER database for 6151 patients with stage III/IV TSCC (American Joint Committee on Cancer (AJCC) staging), diagnosed between 2004 and 2015, was performed. The patients were divided into two groups: palliative surgery and no surgery. Kaplan–Meier and Cox proportional hazards regression analyses were applied to determine risk factors for overall survival (OS) and cancer-specific survival (CSS). A further analysis was performed using 1:1 propensity score matching (PSM) to balance 13 patient variables (sex, age at diagnosis, race, marital status, primary tumour site, SEER stage, AJCC stage, pathological differentiation grade, tumour size, lymph node metastasis, previous lymph node removal, radiotherapy, and chemotherapy). Among the 6151 patients, 706 underwent palliative surgery; the other 5445 did not undergo any kind of surgery. Those who underwent palliative surgery had a higher 5-year survival rate. After PSM, 1274 patients were included in the matched cohort. Multivariate Cox regression analysis showed that patients who underwent palliative surgery had a lower risk of death than those who did not (OS: hazard ratio 0.58, 95% confidence interval 0.49–0.69, P < 0.001; CSS: hazard ratio 0.60, 95% confidence interval 0.49–0.74, P < 0.001). In this comparative study it was found that compared with no surgery, palliative surgery has a positive impact on the survival rate of patients with advanced TSCC.

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