Postoperative radiotherapy in patients with early tumors (pT1 – 2) and a single ipsilateral lymph node metastasis (pN1)

Background:

Indication for postoperative radiotherapy in patients with early tumors (pT1 – 2) and a single ipsilateral lymph node metastasis (pN1) is still debated. Aim of this study was to evaluate the oncologic outcome for postoperative radiotherapy in patients with pT1 – 2 pN1 squamous cell carcinoma (SCC) of the oral cavity, the oro- and hypopharynx.

Methods:

65 consecutive patients with pT1 – 2 pN1 SCC without extranodal extension (7th Edition of the UICC staging manual) were included in this retrospective study. All patients underwent transoral laser microsurgery and neck dissection primarily at an academic tertiary referral center. Resection status was histologically proven being free of disease (R0).

Results:

Of the in total 65 patients (18 oral cavity, 30 oro-, 17 hypopharynx), 21 (32%) received postoperative radiotherapy, 44 (68%) were treated solely surgically. The group of patients receiving the postoperative treatment showed a significantly better 5-year disease-specific (94.4% vs. 73.2%; p = 0.029) and recurrence-free survival (85.2% vs. 43.2%; p = 0.002), and a higher local control rate (90.2% vs. 64.9%; p = 0.042). The overall survival was 71.4% vs. 62.6% (p = 0.53). Mean follow-up was 80.7 months.

Conclusion:

Patients with early tumors and a single ipsilateral lymph node metastasis benefited from postoperative radiotherapy.

Publication History

Publication Date:
23 April 2019 (online)