The Benefit of Adjuvant Radiation in Surgically-Treated T1-2 N1 Oropharyngeal Squamous Cell Carcinoma

Laryngoscope Investig Otolaryngol. 2017 Feb 2;2(2):57-62. doi: 10.1002/lio2.64. eCollection 2017 Apr.

Abstract

Importance: The benefit of adjuvant radiation in surgically treated T1-2N1 oropharyngeal cancer without adverse pathologic features remains unclear.

Objectives: To compare population-level survival outcomes in surgically-treated T1-2N1 oropharyngeal squamous cell carcinoma (OPSCC) with and without the use of adjuvant radiation.

Study design: Retrospective population-based study using the Surveillance, Epidemiology, and End Results (SEER) registry data from 1998-2011.

Setting: Population-level study.

Participants: Patients with T1-2N1 OPSCC treated with surgical resection and neck dissection with or without adjuvant radiation.

Interventions for clinical trials or exposures for observational studies: The use of postoperative adjuvant radiation.

Main outcomes and measures: Overall and disease-specific survival.

Results: Radiation was utilized in 74% of patients and was positively associated with extracapsular extension and well-differentiated histology. The use of radiation was associated with improved mean overall survival (124 v. 108 months, p=0.023) and a non-significant increase in mean disease-specific survival (138 v. 131 months, p=0.053).

Conclusions and relevance: The use of adjuvant radiation is associated with improved survival in surgically-treated T1-2N1 squamous cell carcinoma of the oropharynx with unknown HPV status.

Level of evidence: IV.

Keywords: N1; Oropharynx; TORS; base of tongue; lymph node; radiation; robotic; squamous cell carcinoma; surgery; survival; tonsil.