The Application of Adjuvant Radiotherapy in pN1 OSCC Patients Without Adverse Pathologic Features

Area of Science:

• Oncology
• Head and Neck Surgery
• Radiation Oncology

Background:

• Oral squamous cell carcinoma (OSCC) is a common malignancy.
• Adjuvant radiotherapy is a standard treatment modality for various cancer types.
• Its role in early-stage OSCC with specific pathological features requires clarification.

Purpose of the Study:

• To evaluate the necessity and impact of adjuvant radiotherapy in pN1 oral squamous cell carcinoma patients.
• To determine if adjuvant radiotherapy improves survival outcomes in early-stage (T1-2N1M0) OSCC without adverse pathological features.
• To compare outcomes between patients who received and did not receive adjuvant radiotherapy.

Main Methods:

• A multicenter cohort study involving 231 patients with pN1 oral squamous cell carcinoma.
• Patients were stratified based on whether they received adjuvant radiotherapy post-surgery.
• Kaplan-Meier survival analysis was employed to compare disease-free survival, overall survival, and disease-specific survival.

Main Results:

• No significant differences in survival outcomes were observed between radiotherapy and non-radiotherapy groups for T1-2N1M0 patients without adverse pathological features.
• Statistically significant improvements in disease-free survival, overall survival, and disease-specific survival were noted for T3-4aN1M0 patients receiving adjuvant radiotherapy.
• After-recurrence survival did not differ significantly between the groups.

Conclusions:

• Adjuvant radiotherapy does not enhance prognosis for T1-2N1M0 oral squamous cell carcinoma patients lacking adverse pathological features.
• Adjuvant radiotherapy is recommended for T3-4aN1M0 oral squamous cell carcinoma patients to improve survival.
• Treatment decisions for adjuvant radiotherapy should be individualized based on tumor stage and pathological characteristics.