Effect of neoadjuvant chemotherapy on surgical margin in tongue cancer

Abstract

The benefits of neoadjuvant chemotherapy (NAC) for patients with locally advanced head and neck cancer include a reduction in distant metastasis and the preservation of organ function; however, NAC has failed to demonstrate any significant improvement of survival in several randomized control trials. The efficacy of NAC is controversial, and no report supports NAC with a high level of evidence. We retrospectively analyzed 73 patients who underwent radical surgery for tongue cancer, and examined the effect of NAC on surgical margin.
NAC, regional lymph node metastasis, depth of invasion, local recurrence, perineural invasion, and the status of the surgical margin were identified as factors influencing survival. Moreover, NAC increased the local recurrence rate over that in patients without NAC. The deep surgical margin was resected closely in many NAC-treated cases, suggesting that NAC may lead to local recurrence and a poor outcome. We identified the ABCG2 (cancer stem cell marker) positive cells at the tumor / host interface in NAC-treated recurrent cases, and suggested that the local recurrence in NAC-treated cases may be associated with cancer stem cells.