Postoperative Chemoradiotherapy versus Radiotherapy Alone in Major Salivary Gland Cancers: A Stratified Study Based on the External Validation of the Distant Metastasis Risk Score Model
Background: The role of additional chemoradiotherapy (CRT) for distant metastasis (DM) on the resected malignancy of the major salivary gland (SGM) remained unknown. We conducted this study to externally validate a recently reported DM risk score model and compare the survival outcome between adjuva...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-11-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/22/5583 |
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| author | Wenbin Yan Lili Huang Jianyun Jiang Chunying Shen Xiaomin Ou Chaosu Hu |
| author_facet | Wenbin Yan Lili Huang Jianyun Jiang Chunying Shen Xiaomin Ou Chaosu Hu |
| author_sort | Wenbin Yan |
| collection | DOAJ |
| description | Background: The role of additional chemoradiotherapy (CRT) for distant metastasis (DM) on the resected malignancy of the major salivary gland (SGM) remained unknown. We conducted this study to externally validate a recently reported DM risk score model and compare the survival outcome between adjuvant CRT and RT alone. Materials: We retrospectively reviewed the patients with SGM following postoperative radiotherapy (PORT). The cumulative incidence of DM was assessed using a competing risk method. Multivariate analysis was performed with Cox proportional-hazards regression to identify significant predictors for DM. Patients were classified as high- and low-risk subgroups with the cutoff value of the DM risk score model. The inverse probability of treatment weighting (IPTW) was conducted to minimize the bias of the groups. Results: A total of 586 eligible patients were analyzed and 67 cases underwent adjuvant CRT. The 5-year incidence of DM was 19.5% (95% CI 16.0–23.0%). The model reasonably discriminated the DM risk between the high- and low-risk subgroup in our cohort, and the c-index was 0.75. No survival benefit was observed for the CRT group compared with RT alone in the entire cohort after IPTW (<i>p</i> = 0.095). After subgroup analysis, increased mortality was identified with the administration of CRT in the low-risk subset (<i>p</i> = 0.002) while no significant difference in OS was illustrated in the high-risk subgroup (<i>p</i> = 0.98). Conclusions: This external validation provides further exploration of the DM risk score model in major SGM. Our results demonstrated no support for the utility of additional chemotherapy to PORT in the major SGM, especially in the low-risk subgroup of patients with DM. |
| first_indexed | 2024-03-09T18:26:18Z |
| format | Article |
| id | doaj.art-58a907c87f104cdf8ba0e3de28147990 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T18:26:18Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-58a907c87f104cdf8ba0e3de281479902023-11-24T07:53:31ZengMDPI AGCancers2072-66942022-11-011422558310.3390/cancers14225583Postoperative Chemoradiotherapy versus Radiotherapy Alone in Major Salivary Gland Cancers: A Stratified Study Based on the External Validation of the Distant Metastasis Risk Score ModelWenbin Yan0Lili Huang1Jianyun Jiang2Chunying Shen3Xiaomin Ou4Chaosu Hu5Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, ChinaDepartment of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, ChinaDepartment of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, ChinaDepartment of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, ChinaDepartment of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, ChinaDepartment of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, ChinaBackground: The role of additional chemoradiotherapy (CRT) for distant metastasis (DM) on the resected malignancy of the major salivary gland (SGM) remained unknown. We conducted this study to externally validate a recently reported DM risk score model and compare the survival outcome between adjuvant CRT and RT alone. Materials: We retrospectively reviewed the patients with SGM following postoperative radiotherapy (PORT). The cumulative incidence of DM was assessed using a competing risk method. Multivariate analysis was performed with Cox proportional-hazards regression to identify significant predictors for DM. Patients were classified as high- and low-risk subgroups with the cutoff value of the DM risk score model. The inverse probability of treatment weighting (IPTW) was conducted to minimize the bias of the groups. Results: A total of 586 eligible patients were analyzed and 67 cases underwent adjuvant CRT. The 5-year incidence of DM was 19.5% (95% CI 16.0–23.0%). The model reasonably discriminated the DM risk between the high- and low-risk subgroup in our cohort, and the c-index was 0.75. No survival benefit was observed for the CRT group compared with RT alone in the entire cohort after IPTW (<i>p</i> = 0.095). After subgroup analysis, increased mortality was identified with the administration of CRT in the low-risk subset (<i>p</i> = 0.002) while no significant difference in OS was illustrated in the high-risk subgroup (<i>p</i> = 0.98). Conclusions: This external validation provides further exploration of the DM risk score model in major SGM. Our results demonstrated no support for the utility of additional chemotherapy to PORT in the major SGM, especially in the low-risk subgroup of patients with DM.https://www.mdpi.com/2072-6694/14/22/5583salivary gland malignancychemoradiotherapyexternal validation |
| spellingShingle | Wenbin Yan Lili Huang Jianyun Jiang Chunying Shen Xiaomin Ou Chaosu Hu Postoperative Chemoradiotherapy versus Radiotherapy Alone in Major Salivary Gland Cancers: A Stratified Study Based on the External Validation of the Distant Metastasis Risk Score Model Cancers salivary gland malignancy chemoradiotherapy external validation |
| title | Postoperative Chemoradiotherapy versus Radiotherapy Alone in Major Salivary Gland Cancers: A Stratified Study Based on the External Validation of the Distant Metastasis Risk Score Model |
| title_full | Postoperative Chemoradiotherapy versus Radiotherapy Alone in Major Salivary Gland Cancers: A Stratified Study Based on the External Validation of the Distant Metastasis Risk Score Model |
| title_fullStr | Postoperative Chemoradiotherapy versus Radiotherapy Alone in Major Salivary Gland Cancers: A Stratified Study Based on the External Validation of the Distant Metastasis Risk Score Model |
| title_full_unstemmed | Postoperative Chemoradiotherapy versus Radiotherapy Alone in Major Salivary Gland Cancers: A Stratified Study Based on the External Validation of the Distant Metastasis Risk Score Model |
| title_short | Postoperative Chemoradiotherapy versus Radiotherapy Alone in Major Salivary Gland Cancers: A Stratified Study Based on the External Validation of the Distant Metastasis Risk Score Model |
| title_sort | postoperative chemoradiotherapy versus radiotherapy alone in major salivary gland cancers a stratified study based on the external validation of the distant metastasis risk score model |
| topic | salivary gland malignancy chemoradiotherapy external validation |
| url | https://www.mdpi.com/2072-6694/14/22/5583 |
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