Postoperative radiation therapy vs observation for pN1 oral cavity squamous cell carcinoma. Issue 12 (7th October 2019)

• Record Type: Journal Article
• Authors: Suresh, Krish; Cramer, John D.
• Is Part Of: Head & neck. Volume 41:Issue 12(2019)
• Page Start: 4136
• Page End: 4142
• Publication Date: 2019-10-07
• Subjects: adjuvant radiotherapy -- adverse features -- metastatic lymphadenopathy -- neck dissection -- oral cavity cancer -- postoperative radiotherapy; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.25958
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: Background: American Society of Clinical Oncology guidelines recommend that the decision to give postoperative radiotherapy (PORT) for pN1 oral cavity squamous cell carcinoma (OCSCC) without other adverse features be based on the adequacy of the neck dissection (<18 or ≥18 nodes). Methods: We conducted a cohort study of the National Cancer Database examining how PORT affects survival. We stratified analyses by the adequacy of the neck dissection and lymph node (LN) size. Results: Our cohort comprised 1909 patients (898 received PORT). PORT conferred a survival benefit in the overall cohort (adjusted hazard ratio 0.82, 95% CI 0.72‐0.94). There was similar benefit in patients receiving inadequate and adequate neck dissections. Patients with >10 mm LN metastasis derived greater benefit compared with patients with smaller metastases. Conclusions: In pN1 OCSCC without other adverse features, the size of the LN metastases may predict benefit from PORT, whereas the adequacy of the neck dissection may not.