Supplementary Materialsoncotarget-06-18707-s001. 61.1%, 52.7%, 55.2%, and 60.4%, respectively. There were no significant differences in survival rates NSC 23766 ic50 between experimental and control groups. However, patients with favorable pathologic responses had improved outcomes compared to those with unfavorable pathologic responses and to those in the control group. Although TPF induction chemotherapy did not improve long-term survival compared to surgery upfront in patients with stage III and NSC 23766 ic50 IVA OSCC, a favorable pathologic response after induction chemotherapy may be used as a major endpoint and prognosticator in future studies. Furthermore, the negative results observed in this trial may be represent type II error from an underpowered study. Future larger scale phase III trials are warranted to investigate whether a substantial benefit is present for TPF induction chemotherapy in surgically handled OSCC. = 0.023 for OS; HR = 0.327, 95%CWe:0.147-0.728, = 0.006 for DFS; HR = 0.288, 95%CI:0.122-0.679, = 0.004 for LRFS; HR = 0.372, 95%CWe:0.156-0.885, = 0.025 for DMFS). Furthermore, the individuals with beneficial pathologic reactions got an improved Operating-system also, DFS, LRFS, and DMFS than those in the control group (HR = 0.347, 95%CI:0.149-0.806, = 0.014 for OS; HR = 0.322, 95%CWe:0.148-0.702, = 0.004 for DFS; HR = 0.301, 95%CI:0.13-0.696, = 0.005 for LRFS; HR = 0.337, 95%CI:0.145-0.781, = 0.011 for DMFS). Nevertheless, the variations in Operating-system, DFS, LRFS and DMFS between your individuals without favorable pathologic responses and the patients in the control group were not significant (Figure ?(Figure3,3, Figure S1). Open in a separate window Figure 3 Comparison of overall survival, disease-free survival, locoregional recurrence-free survival and distant metastasis-free survival between the patients with favorable and unfavorable pathologic responses (upper panel), between favorable pathologic responses and the control group (middle panel), and between unfavorable pathologic responses and the control group (lower panel) Locoregional recurrence and distant metastasis There was a trend towards a lower incidence of locoregional recurrence, distant metastasis, and secondary neoplasms for patients who received induction chemotherapy compared to upfront surgery; however, the difference was not significant (Table S1). The subgroup analysis showed no significant benefit from TPF induction chemotherapy in any of the subgroups, with the exception of cN2 patients, who seemed to have improved OS (HR = 0.466, 95%CI:0.221-0.98, = 0.044) and DMFS (HR = 0.468, 95%CI:0.223-0.986, = 0.046) as well as female patients, who had improved DFS (HR = 0.515,95%CI:0.267-0.992, = 0.047) and LRFS (HR = 0.505,95%CI:0.257-0.993, = 0.048) after TPF induction chemotherapy (Figure ?(Figure44). Open in a separate window Figure 4 Subgroup analysis of overall survival, disease-free survival, locoregional recurrence-free survival and distant metastasis-free survival between FUT4 the experimental and control groups Late adverse events (AEs) No severe late AEs were found during the follow-up period of the patients. Surgical margins examined by immunohistochemistry Among the 35 OSCC patients from 1985 to 1987, eight patients (22.9%) were found to have pan-cytokeratin positive surgical margins, which were previously examined and reported to be negative from tumor cells using hematoxylin and eosin staining. Among the 14 patients from 2000 to 2002 and 19 patients from 2008 to 2010, no patients were found to have pan-cytokeratin positive surgical margins. DISCUSSION The long-term follow-up results of this trial demonstrated that TPF induction chemotherapy did not improve survival when compared to surgery upfront in OSCC. However, patients who received TPF induction and had a favorable pathologic response had a decreased risk for death and tumor recurrence compared to those who did not have a favorable pathologic NSC 23766 ic50 response and those did not receive TPF induction chemotherapy. This trial also underscores the importance of complete resection of the primary tumor including use of frozen sections during surgery to confirm adequate margins for R0 resection. Since our practice changed to include intra-operative margin evaluation in 1990s, there was a significant reduction in the.