R0 resection following neoadjuvant PD-1 inhibition with paclitaxel-cisplatin is associated with improved overall survival in locally advanced and recurrent oral squamous cell carcinoma: multicenter retrospective cohort study.
6 affiliations
- 1Department of Head and Neck Surgery, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China.
- 2Department of Pathology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China.
- 3Department of Maxillofacial-Head and Neck Surgery, Liuyang Hospital of Traditional Chinese Medicine, Changsha, Hunan Province, China.
- 4Department of Otolaryngology, Liling Hospital of Traditional Chinese Medicine, Zhuzhou, Hunan Province, China.
- 5Hunan Key Laboratory of Cancer Metabolism, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China.
- 6Department of Head and Neck Radiotherapy, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China.
Abstract
Background
Locally advanced oral squamous cell carcinoma (LA-OSCC) has poor prognosis with standard therapy; recurrent disease is palliative. We compared neoadjuvant PD-1 inhibition plus paclitaxel-cisplatin followed by R0 resection ± radiotherapy versus non-surgical treatment in treatment-naive and recurrent LA-OSCC.Methods
This multicenter retrospective study (2021-2024) included 178 stage III-IVb LA-OSCC patients (43 recurrent, 135 treatment-naive) receiving neoadjuvant chemoimmunotherapy. The primary endpoint was overall survival (OS), analyzed using multivariable time-dependent Cox regression, propensity score matching (PSM), inverse probability of treatment weighting (IPTW), and landmark analyses.Results
The overall response rate was 66.3%; the pathological complete response rate among 117 surgical patients was 35.0%. Responders had better OS than non-responders (HR 0.19, 95%CI 0.11-0.32, p < 0.001). Surgery was associated with improved OS versus non-surgical management (HR 0.23, 95%CI 0.13-0.39, p < 0.001), and the association remained consistent after multivariable adjustment (HR 0.29, 95%CI 0.16-0.52), PSM (47 pairs; HR 0.34, 95%CI 0.17-0.66), IPTW (HR 0.36, 95% CI 0.18-0.74), and 6-month landmark analysis (HR 0.22, 95%CI 0.13-0.39). Radiotherapy was also associated with improved OS (HR 0.43, 95%CI 0.21-0.87, p = 0.018); postoperative radiotherapy was associated with longer OS than surgery alone (HR 0.43, 95%CI 0.16-0.98, p = 0.047), and surgery was associated with improved OS in recurrent disease (HR 0.47, 95%CI 0.21-0.99, p = 0.049).Conclusion
In treatment-naive and recurrent LA-OSCC, neoadjuvant chemoimmunotherapy followed by response-directed R0 resection and risk-adapted radiotherapy was associated with improved OS. These retrospective associations warrant confirmation in prospective randomized trials.
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BibTeX
@article{wang2026resection,
title = {{R0 resection following neoadjuvant PD-1 inhibition with paclitaxel-cisplatin is associated with improved overall survival in locally advanced and recurrent oral squamous cell carcinoma: multicenter retrospective cohort study.}},
author = {Qiwei Wang and Yan Liu and Liang Zuo and Shuichao Gao and Jiaming Chen and Lei Xue and Ping Li and Xiaoqing Lei and Jingguan Lin and Yaqian Han and Hekun Jin and Yujuan Zhou and Hao Tian},
journal = {Annals of medicine},
year = {2026},
month = oct,
doi = {10.1080/07853890.2026.2744077},
url = {https://europepmc.org/article/MED/42954036},
note = {CC BY},
}
RIS
TY - JOUR
TI - R0 resection following neoadjuvant PD-1 inhibition with paclitaxel-cisplatin is associated with improved overall survival in locally advanced and recurrent oral squamous cell carcinoma: multicenter retrospective cohort study.
AU - Qiwei Wang
AU - Yan Liu
AU - Liang Zuo
AU - Shuichao Gao
AU - Jiaming Chen
AU - Lei Xue
AU - Ping Li
AU - Xiaoqing Lei
AU - Jingguan Lin
AU - Yaqian Han
AU - Hekun Jin
AU - Yujuan Zhou
AU - Hao Tian
PY - 2026
DA - 2026/10/29
JO - Annals of medicine
DO - 10.1080/07853890.2026.2744077
UR - https://europepmc.org/article/MED/42954036
AB - Background Locally advanced oral squamous cell carcinoma (LA-OSCC) has poor prognosis with standard therapy; recurrent disease is palliative. We compared neoadjuvant PD-1 inhibition plus paclitaxel-cisplatin followed by R0 resection ± radiotherapy versus non-surgical treatment in treatment-naive and recurrent LA-OSCC.Methods This multicenter retrospective study (2021-2024) included 178 stage III-IVb LA-OSCC patients (43 recurrent, 135 treatment-naive) receiving neoadjuvant chemoimmunotherapy. The primary endpoint was overall survival (OS), analyzed using multivariable time-dependent Cox regression, propensity score matching (PSM), inverse probability of treatment weighting (IPTW), and landmark analyses.Results The overall response rate was 66.3%; the pathological complete response rate among 117 surgical patients was 35.0%. Responders had better OS than non-responders (HR 0.19, 95%CI 0.11-0.32, p < 0.001). Surgery was associated with improved OS versus non-surgical management (HR 0.23, 95%CI 0.13-0.39, p < 0.001), and the association remained consistent after multivariable adjustment (HR 0.29, 95%CI 0.16-0.52), PSM (47 pairs; HR 0.34, 95%CI 0.17-0.66), IPTW (HR 0.36, 95% CI 0.18-0.74), and 6-month landmark analysis (HR 0.22, 95%CI 0.13-0.39). Radiotherapy was also associated with improved OS (HR 0.43, 95%CI 0.21-0.87, p = 0.018); postoperative radiotherapy was associated with longer OS than surgery alone (HR 0.43, 95%CI 0.16-0.98, p = 0.047), and surgery was associated with improved OS in recurrent disease (HR 0.47, 95%CI 0.21-0.99, p = 0.049).Conclusion In treatment-naive and recurrent LA-OSCC, neoadjuvant chemoimmunotherapy followed by response-directed R0 resection and risk-adapted radiotherapy was associated with improved OS. These retrospective associations warrant confirmation in prospective randomized trials.
SN - 0785-3890
SN - 1365-2060
ER -