Benefit-risk appraisal of lip-split mandibular “swing” vs. transoral approaches to posterior oral/oropharyngeal carcinomas using number needed to treat, to harm, and likelihood to be helped or harmed
Issued Date
2022-09-01
Resource Type
ISSN
09607404
eISSN
18793320
Scopus ID
2-s2.0-85135963797
Pubmed ID
35985085
Journal Title
Surgical Oncology
Volume
44
Rights Holder(s)
SCOPUS
Bibliographic Citation
Surgical Oncology Vol.44 (2022)
Suggested Citation
Pitak-Arnnop P., Witohendro L.K., Tangmanee C., Subbalekha K., Sirintawat N., Auychai P., Meningaud J.P., Neff A. Benefit-risk appraisal of lip-split mandibular “swing” vs. transoral approaches to posterior oral/oropharyngeal carcinomas using number needed to treat, to harm, and likelihood to be helped or harmed. Surgical Oncology Vol.44 (2022). doi:10.1016/j.suronc.2022.101837 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85586
Title
Benefit-risk appraisal of lip-split mandibular “swing” vs. transoral approaches to posterior oral/oropharyngeal carcinomas using number needed to treat, to harm, and likelihood to be helped or harmed
Other Contributor(s)
Abstract
Purpose: s: To evaluate benefit-risk profiles of lip-split mandibular “swing” vs. transoral approaches (LS-MSA; TOA) to the American Joint Committee on Cancer (AJCC) stage I-III posterior oral/oropharyngeal carcinomas (PO/OPC). Methods: Using a retrospective double-cohort study design, we enrolled stage I-III PO/OPC patients treated in two German medical centers during a 4-year interval. The predictor variable was surgical technique (LS-MSA/TOA), and main outcomes were complete resection with R0 margins (CR-R0), 5-year overall survival and recurrence (OS5; R5), and adverse events (AEs). Descriptive and bivariate statistics were computed with α = 95%. Benefit-risk profiles were investigated using number needed to treat (NNT), to harm (NNH), and likelihood to be helped or harmed (LLH). Results: At 5-year follow-ups of 202 subjects, LS-MSA caused significantly better CR-R0 (P = 0.001; NNT: 4) and fewer R5 (P = 0.003; NNT: 5), but more risks of wound dehiscence ([WD]; P = 0.01; NNH = 8), and orocutaneous fistula ([OCF]; P = 0.01; NNH: 10). LLH calculations demonstrated that LS-MSA was 2 and 1.6 times more likely to result in CR-R0 and fewer R5 than an incident of WD. There was no significant difference in OS5, postoperative infections (within 30 postoperative days) and AE domains according to the University of Washington Quality of Life questionnaire version 4 (UW-QoLv4) between the surgical approach groups. Conclusions: Compared to TOA, LS-MSA is an efficacious and tolerable intervention for inspecting and eradicating stage I-III PO/OPCs, and reducing recurrences at 5-year follow-ups. Post-LS-MSA WD and OCF require meticulous concerns and more investigations.