Author(s) :
Richa Arunendu1, Deepak Gupta1, Shyam Bisht1, Susovan Banerjee1, Kushal Narang1, Mayur Mayank1, Sorun Shishak1, Tejinder Kataria1
1 Department of Radiation Oncology, Medanta the Medicity, Gurgaon, India
Corresponding author: Deepak Gupta, Email: richa.arunendu@gmail.com
Publication History: Received - 21 September 2025, Revised - 20 March 2026, Accepted - 30 April 2026, Published Online - 30 September 2026.
Copyright: © 2026 The author(s). Published by Casa Cărții de Știință.
User License: Creative Commons Attribution – NonCommercial (CC BY-NC)
Share
Abstract
Objective: To analyze the outcomes and failure pattern in major (>2 mm) extranodal extension (ENE) in oral cavity cancers receiving multimodality treatment.
Materials and Methods: In this single institution cohort study, we prospectively collected and analyzed the clinical and radiological data of 62 consecutive patients with major ENE (>2mm) positive resectable oral cavity cancers treated with multimodality therapy, between January 2015 to December 2021.
Results: 62 patients (7/62 (11.2%) women and 55/62 (88.7%) men; median [range] age, 56 [27 – 86] years) with stage IV major ENE positive oral cavity cancers were treated by postoperative chemoradiation. The median follow-up was 98 months (ranging from 5.17 to 121 months). 36/62 (58%) failures were observed, among them the majority of failures i.e. 16/36 patients (44.4%) occurred at distant metastatic sites, and 13/36 patients (36.1%) had infield recurrences. Notably no marginal failure was observed. The median overall survival (OS) was 44.27 months. The median disease-free survival (DFS) was 24.17 months. Multivariate analysis showed that Pan/Gutka/Tobacco chewing was significantly associated with worse 5-year DFS and OS of 14.4% and 35.6% respectively.
Conclusion: Distant failure (50 – 58%) was the predominant cause of treatment failure and combined with the history of tobacco intake, it further led to poor survival outcomes.