PMID- 35985085
OWN - NLM
STAT- MEDLINE
DCOM- 20221012
LR  - 20221012
IS  - 1879-3320 (Electronic)
IS  - 0960-7404 (Linking)
VI  - 44
DP  - 2022 Sep
TI  - 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.
PG  - 101837
LID - S0960-7404(22)00132-3 [pii]
LID - 10.1016/j.suronc.2022.101837 [doi]
AB  - 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 R(0) margins (CR-R(0)), 5-year overall survival and 
      recurrence (OS(5); R(5)), and adverse events (AEs). Descriptive and bivariate 
      statistics were computed with alpha = 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-R(0) (P = 0.001; NNT: 4) and fewer R(5) (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-R(0) and fewer R(5) 
      than an incident of WD. There was no significant difference in OS(5), 
      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.
CI  - Copyright (c) 2022 Elsevier Ltd. All rights reserved.
FAU - Pitak-Arnnop, Poramate
AU  - Pitak-Arnnop P
AD  - Department of Oral and Craniomaxillofacial Plastic Surgery, UKGM GmbH, University 
      Hospital Marburg, Faculty of Medicine, Philipps-University of Marburg, Marburg, 
      Germany. Electronic address: poramate.pitakarnnop@gmail.com.
FAU - Witohendro, Levyn Kay
AU  - Witohendro LK
AD  - Faculty of Medicine, Goethe University, Frankfurt am Main, Germany.
FAU - Tangmanee, Chatpong
AU  - Tangmanee C
AD  - Department of Statistics, Chulalongkorn University Business School, Bangkok, 
      Thailand.
FAU - Subbalekha, Keskanya
AU  - Subbalekha K
AD  - Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn 
      University, Bangkok, Thailand.
FAU - Sirintawat, Nattapong
AU  - Sirintawat N
AD  - Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol 
      University, Bangkok, Thailand.
FAU - Auychai, Prim
AU  - Auychai P
AD  - Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn 
      University, Bangkok, Thailand.
FAU - Meningaud, Jean-Paul
AU  - Meningaud JP
AD  - Department of Plastic, Reconstructive, Esthetic and Maxillofacial Surgery, Henri 
      Mondor University Hospital, AP-HP, Faculty of Medicine, University Paris-Est 
      Creteil Val de Marne (Paris XII), Creteil, France.
FAU - Neff, Andreas
AU  - Neff A
AD  - Department of Oral and Craniomaxillofacial Plastic Surgery, UKGM GmbH, University 
      Hospital Marburg, Faculty of Medicine, Philipps-University of Marburg, Marburg, 
      Germany.
LA  - eng
PT  - Journal Article
DEP - 20220815
PL  - Netherlands
TA  - Surg Oncol
JT  - Surgical oncology
JID - 9208188
SB  - IM
MH  - *Carcinoma
MH  - Cohort Studies
MH  - Humans
MH  - Lip
MH  - *Mouth Neoplasms/surgery
MH  - Quality of Life
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Benefit-risk profile
OT  - Oral cancer
OT  - Oropharyngeal cancer
OT  - Surgical approach
EDAT- 2022/08/20 06:00
MHDA- 2022/10/13 06:00
CRDT- 2022/08/19 18:15
PHST- 2022/05/09 00:00 [received]
PHST- 2022/07/18 00:00 [revised]
PHST- 2022/08/08 00:00 [accepted]
PHST- 2022/08/20 06:00 [pubmed]
PHST- 2022/10/13 06:00 [medline]
PHST- 2022/08/19 18:15 [entrez]
AID - S0960-7404(22)00132-3 [pii]
AID - 10.1016/j.suronc.2022.101837 [doi]
PST - ppublish
SO  - Surg Oncol. 2022 Sep;44:101837. doi: 10.1016/j.suronc.2022.101837. Epub 2022 Aug 
      15.