Oral oncology最新文献

{"title":"Subcutaneous amivantamab in recurrent/metastatic head and neck squamous cell cancer after disease progression on checkpoint inhibitor and chemotherapy: Preliminary results from the phase 1b/2 OrigAMI-4 study","authors":"Kevin J. Harrington ,&nbsp;Ari J. Rosenberg ,&nbsp;Muh-Hwa Yang ,&nbsp;Jessica L. Geiger ,&nbsp;Marc Oliva ,&nbsp;Myung-Ju Ahn ,&nbsp;Sun Min Lim ,&nbsp;William Ince ,&nbsp;Aarti Bhatia ,&nbsp;Siddharth Sheth ,&nbsp;Bhumsuk Keam ,&nbsp;Robert Metcalf ,&nbsp;Joshua C. Curtin ,&nbsp;Kiichiro Toyoizumi ,&nbsp;Mark Wade ,&nbsp;Emrullah Yilmaz ,&nbsp;Priya Kim ,&nbsp;Remy B. Verheijen ,&nbsp;Sujay Shah ,&nbsp;Mahadi Baig ,&nbsp;Paul L. Swiecicki","doi":"10.1016/j.oraloncology.2025.107791","DOIUrl":"10.1016/j.oraloncology.2025.107791","url":null,"abstract":"<div><div>Overexpression of EGFR and MET occurs in a high proportion of recurrent and/or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC). Amivantamab, an EGFR-MET bispecific antibody with immune-cell directing activity, is approved in <em>EGFR</em>-mutated advanced non-small cell lung cancer and is being evaluated in phase 3 trials for other solid tumors. Cohort 1 of OrigAMI-4 (NCT06385080) enrolled adult participants with human papillomavirus–unrelated R/M HNSCC with disease progression on/after prior checkpoint inhibitor and platinum-based chemotherapy. Subcutaneous amivantamab was administered at 1600 mg (2240 mg for ≥ 80 kg body weight) on Cycle 1 Day 1 and 2400 mg (3360 mg for ≥ 80 kg body weight) thereafter. Primary end point was investigator-assessed objective response rate (ORR). As of July 1, 2025 (median follow-up, 3.5 months [range, 0–13.4]), 86 participants (median age, 63.5 years; 45 % Asian; 43 % White) received ≥ 1 dose of subcutaneous amivantamab. Subcutaneous amivantamab was well tolerated. Administration-related reactions were reported in 7 % (n = 6/86) of participants; no new safety signals were observed. In the efficacy population (n = 38; median follow-up, 8.3 months [range, 1.1–13.4]), confirmed ORR was 45 % (95 % CI, 29 %–62 %), median time to first response was 6.4 weeks (range, 5.7–18.3), and median duration of response was 7.2 months (95 % CI, 5.3–NE). The clinical benefit rate (responder or durable stable disease) was 76 % (95 % CI, 60 %–89 %). Median progression-free survival was 6.8 months (95 % CI, 4.2–9.0). Subcutaneous amivantamab as second-/third-line treatment among participants with R/M HNSCC demonstrated rapid and durable antitumor activity. The safety profile of subcutaneous amivantamab was consistent with previous studies.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"171 ","pages":"Article 107791"},"PeriodicalIF":3.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning process of transoral robotic surgery for head and neck cancers: a scoping review","authors":"Jérôme R. Lechien","doi":"10.1016/j.oraloncology.2025.107788","DOIUrl":"10.1016/j.oraloncology.2025.107788","url":null,"abstract":"<div><h3>Background</h3><div>The learning curve for Transoral Robotic Surgery (TORS) in head and neck cancer (HNC) management remains incompletely characterized despite its increasing adoption. This systematic review evaluated the learning curves and required case volume for achieving proficiency and identified factors influencing the learning process.</div></div><div><h3>Methods</h3><div>Two investigators conducted a PubMed, Scopus, and Cochrane Library systematic review for studies investigating the surgical, functional, oncological and learning curve outcomes related to the implementation of TORS in HNC surgery using the PRISMA statement. The bias analysis was conducted with the MINORS.</div></div><div><h3>Results</h3><div>Of the 102 identified studies, 9 studies met our inclusion criteria, including 792 (82.1 %) male patients. TORS learning curve was primarily investigated on cT2N1 oropharyngeal cancer. The number of requested cases to achieve inflexion point in performing TORS varied by outcome measures but globally ranges from 25 to 50 cases. The mean MINORS was 8.8 ± 1.8 There was substantial heterogeneity across studies for the definition and criteria used to determine the learning process/inflexion point. No study detailed the surgeon experience and features. Two studies described the training program applied to surgeons before starting the study.</div></div><div><h3>Conclusion</h3><div>TORS proficiency case numbers remain unclear due to study heterogeneity, non-standardized endpoints, and variable definitions. Estimates range 20–50 cases for operative outcomes; long-term results require higher volumes. Future prospective studies are needed to standardize learning definitions and analyze how surgeon-specific factors (experience, age, prior training) impact TORS learning curves.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"171 ","pages":"Article 107788"},"PeriodicalIF":3.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Neoadjuvant chemotherapy combined with anti-PD-1 monoclonal antibody in locally advanced resectable oral squamous cell carcinoma: Efficacy evaluation and prediction","authors":"Yan Liu,&nbsp;Yingchun Zhou,&nbsp;Ming Cai","doi":"10.1016/j.oraloncology.2025.107783","DOIUrl":"10.1016/j.oraloncology.2025.107783","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"171 ","pages":"Article 107783"},"PeriodicalIF":3.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145518016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes and characteristics of patients receiving pre-operative versus post-operative radiotherapy for sinonasal squamous cell carcinoma","authors":"Revadhi C Chelvarajah ,&nbsp;Shao Hui Huang ,&nbsp;Jie Su ,&nbsp;Maru Gete ,&nbsp;Jolie Ringash ,&nbsp;Ian Witterick ,&nbsp;John de Almeida ,&nbsp;Eric Monteiro ,&nbsp;Ralph Gilbert ,&nbsp;Anna Spreafico ,&nbsp;John Waldron ,&nbsp;Brian O’Sullivan ,&nbsp;Ali Hosni ,&nbsp;Scott Bratman ,&nbsp;B.C.John Cho ,&nbsp;Andrew Hope ,&nbsp;John Kim ,&nbsp;Andrew McPartlin ,&nbsp;C.Jillian Tsai ,&nbsp;Li Tong ,&nbsp;Ezra Hahn","doi":"10.1016/j.oraloncology.2025.107794","DOIUrl":"10.1016/j.oraloncology.2025.107794","url":null,"abstract":"<div><h3>Purpose</h3><div>We report our experience with resectable sinonasal squamous cell carcinoma (SNSCC) treated with pre-operative (preop-RT) or postoperative radiotherapy (postop-RT), focusing on oncologic outcomes and patient selection.</div></div><div><h3>Material</h3><div>All SNSCC treated with preop-RT or postop-RT from 2005 to 2021 were included. Clinical characteristics and outcomes were compared between cohorts. Actuarial rates of overall survival (OS), locoregional control (LRC), distant control (DC), and late toxicity were estimated.</div></div><div><h3>Results</h3><div>Among 71 eligible patients, 25 received preop-RT and 46 postop-RT. Preop-RT cohort comprised more ethmoid primary (32 % vs 0 %, p &lt; 0.001) and T3-T4 diseases (versus T1-2) (96 % vs 65 %, p &lt; 0.04), with larger tumors (mean 62 vs 49 cm³, p = 0.02). Reasons for preop-RT included reduced dose and volume of critical organs (n = 16, 64 %), avoidance of orbital exenteration (n = 2, 8 %), maximizing likelihood of achieving clear resection margins (n = 5, 20 %) and other (n = 2, 8 %). Eight (32 %) preop-RT patients had a pathological complete response. Positive resection margin was identified less frequently in the preop-RT (n = 2) vs postop-RT (n = 23) cohorts (8 % vs 50 %, p &lt; 0.001). Five (20 %) patients in the preop-RT cohort had local recurrence (1 residual, 4 recurrence) vs 16 (35 %) in the postop-RT cohort. Five-year actuarial rates of LRC (78 % vs 64 %, p = 0.107), DC (92 % vs 81 %, p = 0.524), OS (76 % vs 65 %, p = 0.912), and grade 3–4 late toxicity (18 % vs 12 %, p = 0.394) were similar between preop-RT and postop-RT cohorts, respectively.</div></div><div><h3>Conclusion</h3><div>Preop-RT achieved similar oncologic outcomes to postop-RT despite higher T-categories, and is a reasonable option for select patients with locally advanced SNSCC in a collaborative multidisciplinary, high-volume setting.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"171 ","pages":"Article 107794"},"PeriodicalIF":3.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensitivity of post-treatment surveillance in detecting recurrence and metastasis in surgically treated HPV-positive oropharyngeal squamous cell carcinoma patients","authors":"Agnes Q Zhu ,&nbsp;Claire E Cassianni ,&nbsp;Travis Haller ,&nbsp;Thomas J. O’Byrne ,&nbsp;Pablo Ochoa ,&nbsp;Tissiana Vallecillo ,&nbsp;Andrew Pumford ,&nbsp;Felicia Olawuni ,&nbsp;Eric J Moore ,&nbsp;Daniel L Price ,&nbsp;Kendall K Tasche ,&nbsp;Linda X Yin ,&nbsp;Daniel J Ma ,&nbsp;Scott C Lester ,&nbsp;Mauricio Gamez ,&nbsp;Michelle A Neben Wittich ,&nbsp;Katharine A Price ,&nbsp;Kathryn M Van Abel ,&nbsp;David M Routman","doi":"10.1016/j.oraloncology.2025.107767","DOIUrl":"10.1016/j.oraloncology.2025.107767","url":null,"abstract":"<div><h3>Introduction</h3><div>There is a lack of data regarding the appropriate surveillance of HPV(+)OPSCC. Our study aims to determine the sensitivity of patient symptoms, physical exam findings, and imaging in identifying recurrence and disease progression.</div></div><div><h3>Methods</h3><div>Mayo Clinic IRB (22–000684) approval was obtained, and the departmental REDCap database was queried to identify all HPV(+)OPSCC patients from 01/01/2006 to 12/31/2021 at our tertiary care center. Surgically treated patients with pathologic specimens positive for HPV (confirmed with in-situ hybridization (ISH) and/or p16 immuno-histochemistry) without evidence of distant metastatic disease at diagnosis were included.<!--> <!-->Sensitivity, specificity, PPV, and NPV of patient symptoms, physical exam findings, and imaging for disease progression were assessed both overall and at each time point.</div></div><div><h3>Results</h3><div>142/1142 patients experienced disease progression. 70% of patients with disease progression were detected within the first two years of surveillance. 79 patients with disease progression were detected via routine surveillance imaging, 34 via patient-reported symptoms, and 5 via physical exam.</div><div>Routine surveillance imaging was the most sensitive method of detection for locoregional recurrence (sensitivity 92.3%, PPV 6.5%, NPV 42.9%) and distant metastasis (sensitivity 100%, PPV 6.7%, NPV 100.0%). Patient symptoms in aggregate had a 73.1% sensitivity for detecting locoregional recurrence (PPV 8.7%, NPV 95.4%); however no individual symptom had a sensitivity over 30%. Physical exam findings were the least sensitive method of detection.</div></div><div><h3>Conclusion</h3><div>Our findings demonstrate that the majority of recurrences are detected within the first two years of surveillance. Routine surveillance imaging is the most sensitive modality for detecting disease progression as compared to patient symptoms or physical exam findings. Additional studies integrating newer technologies, such as ctHPVDNA. into surveillance are needed.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"171 ","pages":"Article 107767"},"PeriodicalIF":3.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145420249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoradionecrosis following post-operative intensity-modulated radiation therapy or proton therapy for oral cavity cancer","authors":"Rupsa Das,&nbsp;Satya Ranjan Misra","doi":"10.1016/j.oraloncology.2025.107796","DOIUrl":"10.1016/j.oraloncology.2025.107796","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"171 ","pages":"Article 107796"},"PeriodicalIF":3.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145605405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of head and neck cancer around the world: an international survey by the world ear, nose, and throat federation","authors":"Victorine Maso ,&nbsp;Jerome R Lechien ,&nbsp;Isabelle Gengler ,&nbsp;Carlos Chiesa-Estomba ,&nbsp;Johannes J. Fagan ,&nbsp;Sheng-Po Hao ,&nbsp;Luiz P. Kowalski ,&nbsp;Bernard Lyons ,&nbsp;Emmanuel Babin ,&nbsp;Mohamad Yunus Mohd Razif ,&nbsp;Hani Z. Marzouki ,&nbsp;Angel Ramos Macias ,&nbsp;Hector E. Ruiz ,&nbsp;Antonino Maniaci ,&nbsp;Bernard Fraysse ,&nbsp;Matthew White ,&nbsp;Justin Michel ,&nbsp;Nicolas Fakhry","doi":"10.1016/j.oraloncology.2025.107766","DOIUrl":"10.1016/j.oraloncology.2025.107766","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate worldwide medical practices of otolaryngology centers in managing patients with Head And Neck Cancer (HNC)</div></div><div><h3>Materials and Methods</h3><div>We performed an online survey sent to otorhinolaryngologists worldwide via the IFOS between February and March 2024. The following aspects were evaluated: personal characteristics, diagnostics modalities, treatments, global management, cultural specificities and clinical cases. We compared results between centers in different geographical areas: Europe, North America, South and Central America, Asia, Africa Sub-Saharan, Oceania, and Middle East &amp; North Africa (MENA).</div></div><div><h3>Results</h3><div>A total of 566 otorhinolaryngologists from 457 centers in 101 countries responded. International guideline adherence was lower in North America (45.5 %) than globally (74.5 %; p = 0.005). HPV/p16 testing was less common in Africa (28.9 %) and MENA (60.8 %) versus other regions (92.8 %; p &lt; 0.001). PD-L1 testing was frequent in Europe (84.6 %) but rare in Africa (5.3 %; p &lt; 0.001). Multidisciplinary Tumor Boards were systematic in Europe (88.9 %) and Oceania (87.5 %) but used selectively elsewhere. Intensity-modulated radiation therapy use was lower in Africa (28.9 %) and MENA (64.6 %; p &lt; 0.001). A total of 95.7 % of centers had access to chemotherapy, with no differences between regions (p = 0.236). African centers cited cost as a major barrier (79.5 % vs. 33.8 %; p &lt; 0.001). MRI and PET/CT access was significantly lower in Africa (51.2 % and 5 %), Central/South America (79.5 % and 47.7 %), and MENA (80.9 % and 43.8 %) than other regions (89.5 % and 73.2 %; p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The management of HNC exhibits significant variability worldwide. International guidelines should consider the economic, cultural, and geographic specificities of each continent to ensure context-sensitive care.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"171 ","pages":"Article 107766"},"PeriodicalIF":3.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145445633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From peripheral tolerance to combination therapy: The translational legacy of the 2025 Nobel Prize","authors":"Fábio Muradás Girardi ,&nbsp;Manoela Domingues Martins ,&nbsp;Lauren Frenzel Schuch","doi":"10.1016/j.oraloncology.2025.107793","DOIUrl":"10.1016/j.oraloncology.2025.107793","url":null,"abstract":"","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"171 ","pages":"Article 107793"},"PeriodicalIF":3.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145569574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"T4a classification for oral cancer using mandibular canal invasion instead of bone marrow invasion in the TNM staging system","authors":"Masaya Okura ,&nbsp;Nobuhiro Yamakawa ,&nbsp;Mitsunobu Otsuru ,&nbsp;Takumi Hasegawa ,&nbsp;Yusuke Yokota ,&nbsp;Shin Rin ,&nbsp;Hironori Sakai ,&nbsp;Shin-ichi Yamada ,&nbsp;Eiji Hirai ,&nbsp;Yuichi Ashikaga ,&nbsp;Kozo Yamamoto ,&nbsp;Michihiro Ueda ,&nbsp;Tadaaki Kirita ,&nbsp;Masahiro Umeda ,&nbsp;Masaya Akashi ,&nbsp;Hiroshi Kurita ,&nbsp;Yoichi Ohiro ,&nbsp;Tomofumi Naruse ,&nbsp;Souichi Yanamoto ,&nbsp;Japan Oral Oncology Group JOOG","doi":"10.1016/j.oraloncology.2025.107771","DOIUrl":"10.1016/j.oraloncology.2025.107771","url":null,"abstract":"<div><h3>Background and purpose</h3><div>In oral cavity cancers, tumors invading the bone marrow of the mandible or maxilla have traditionally been classified as T4a in the TNM staging system. This study evaluated the impact of bone invasion on T classification and survival in patients with squamous cell carcinoma of the oral cavity.</div></div><div><h3>Materials and methods</h3><div>We retrospectively reviewed and restaged 2,143 patients treated between 2001 and 2019. Bone invasion was categorized as no bone invasion, non-mandibular canal (MC) bone marrow invasion, or MC invasion. Disease-specific survival (DSS) was the primary endpoint. Prognostic performance was assessed using Kaplan–Meier analysis and Cox proportional hazards models. Discriminative ability was evaluated with Harrell’s concordance index (C-index) and calibration analysis.</div></div><div><h3>Results</h3><div>Among 505 T4a tumors, 271 (53.7%) were classified as T4a solely due to bone marrow invasion, and their survival outcomes were comparable to those of T3 tumors. In multivariate analysis, MC invasion was independently associated with worse DSS, whereas non-MC bone marrow invasion was not. Based on these findings, we developed two revised versions of the MC-T classification for oral tumors, replacing bone marrow invasion with MC invasion as a T4a criterion in the 8th edition UICC/AJCC T classification. Both MC-T classifications showed superior prognostic discrimination, with higher C-indices than the original system.</div></div><div><h3>Conclusions</h3><div>Patients with T4a oral tumors classified solely by bone marrow invasion had survival outcomes similar to those with T3 tumors. The proposed MC-T classification improves prognostic accuracy by more effectively stratifying T4a tumors.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"171 ","pages":"Article 107771"},"PeriodicalIF":3.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145506328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response-adapted surgery after neoadjuvant immunochemotherapy in oral squamous cell carcinoma","authors":"Qigen Fang ,&nbsp;Junhui Yuan ,&nbsp;Xu Zhang ,&nbsp;Tao Huang ,&nbsp;Lanwei Guo","doi":"10.1016/j.oraloncology.2025.107769","DOIUrl":"10.1016/j.oraloncology.2025.107769","url":null,"abstract":"<div><h3>Objective</h3><div>The standard treatment for locally advanced oral squamous cell carcinoma (OSCC) involves radical surgery followed by adjuvant therapy, often resulting in significant functional impairment. Neoadjuvant immunochemotherapy (NICT) has emerged as a promising strategy to facilitate surgical de-escalation while preserving oncologic outcomes. This study evaluates the feasibility of response-adapted surgery (RAS) following NICT in OSCC.</div></div><div><h3>Methods</h3><div>In this retrospective analysis, 152 patients with previously untreated OSCC received NICT followed by either RAS (n = 66) or traditional surgery (TS, n = 86). RAS was tailored to post-NICT tumor regression, while TS adhered to pretreatment tumor extent. Primary endpoints were 3-year event-free survival (EFS) and overall survival (OS). Secondary endpoints included quality of life (QoL, assessed via EORTC QLQ-HN35) and perioperative complications.</div></div><div><h3>Results</h3><div>The RAS and TS cohorts exhibited comparable 3-year EFS (78.8 % vs. 79.1 %, p = 0.944) and OS (90.9 % vs. 91.9 %, p = 0.826). RAS significantly reduced the need for mandibulectomy (16.7 % vs. 41.9 %, p = 0.009) and free flap reconstruction (15.2 % vs. 48.8 %, p = 0.018), with fewer major complications (4.5 % vs. 11.6 %, p = 0.048). QoL metrics favored RAS, particularly in swallowing (15 ± 3.8 vs. 28 ± 5.5, p &lt; 0.001) and speech (14 ± 3.9 vs. 25 ± 5.2, p &lt; 0.001) at 12 months. Major pathologic response and PD-L1 CPS &gt; 20 were associated with improved survival.</div></div><div><h3>Conclusions</h3><div>RAS after NICT achieves oncologic outcomes equivalent to TS while significantly reducing treatment-related morbidity and improving functional recovery. These findings support RAS as a viable de-escalation strategy for OSCC, aligning with the goals of precision oncology. Prospective trials are needed to validate long-term efficacy and refine patient selection criteria.</div></div>","PeriodicalId":19716,"journal":{"name":"Oral oncology","volume":"171 ","pages":"Article 107769"},"PeriodicalIF":3.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145445656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}