Benefit of postoperative radiotherapy for early tumors with single ipsilateral lymph node metastasis.

Abstract

OBJECTIVES/HYPOTHESIS:

Indication for postoperative radiotherapy in patients with locally circumscribed tumors (pT1-pT2) and a single ipsilateral lymph node metastasis (pN1) is debatable. The aim of this study was to evaluate the oncological long-term outcome of patients with pT1-pT2 pN1 squamous cell carcinoma (SCC) of the oral cavity, the oropharynx, and the hypopharynx without extracapsular spread (ECS) after a margin-negative surgical resection, who either received or did not receive postoperative (chemo)radiotherapy.

STUDY DESIGN:

Retrospective case series.

METHODS:

The oncological outcome of patients with pT1-pT2 pN1 SCC without ECS was evaluated retrospectively. All patients underwent primary tumor resection that included transoral laser microsurgery and neck dissection at an academic tertiary referral center.

RESULTS:

Of 65 identified patients treated between 1986 and 2015 (18 oral cavity, 30 oropharynx, 17 hypopharynx), 21 (32%) received postoperative radiotherapy, and 44 (68%) were treated by surgery alone. The group of patients receiving postoperative treatment showed a significantly superior 5-year disease-specific (94.4% vs. 73.2%, P = .029) and recurrence-free survival (85.2% vs. 43.2%, P = .002), as well as a higher local control rate (90.2% vs. 64.9%, P = .042). The overall survival was 71.4% vs. 62.6% (P = .53). The mean follow-up was 80.7 months.

CONCLUSIONS:

Patients with locally circumscribed carcinomas and a single ipsilateral ECS-negative lymph node metastasis seem to benefit from postoperative radiotherapy.

LEVEL OF EVIDENCE:

4 Laryngoscope, 130:E530-E538, 2020.

• Authors: Bernhard G Weiss, Mahalia Z Anczykowski, Susanne Flach, Jennifer L Spiegel, Julia Kitz, Mattis Bertlich, Martin Canis, Mark Jakob, Friedrich Ihler
• Journal: The Laryngoscope (Laryngoscope) Vol. 130 Issue 10 Pg. E530-E538 (10 2020) ISSN: 1531-4995 [Electronic] United States
• PMID: 31837151 (Publication Type: Journal Article)
• Copyright: © 2019 The Authors. The Laryngoscope published by Wiley Periodicals, Inc. on behalf of The American Laryngological, Rhinological and Otological Society, Inc.

Topics

• Carcinoma, Squamous Cell (pathology, radiotherapy, surgery)
• Female
• Head and Neck Neoplasms (pathology, radiotherapy, surgery)
• Humans
• Laser Therapy
• Lymphatic Metastasis (pathology)
• Male
• Microsurgery
• Middle Aged
• Neck Dissection
• Neoplasm Staging
• Postoperative Care
• Retrospective Studies