Benefit of postoperative radiotherapy in patients with oropharyngeal squamous cell carcinoma in human papillomavirus (HPV) era: A Surveillance, Epidemiology, and End Results (SEER) database analysis

Abstract

Background: This study aimed to investigate the survival benefit of postoperative radiotherapy in patients with resected human papilloma virus-positive oropharyngeal squamous cell carcinoma using data from the Surveillance, Epidemiology, and End Results database.

Methods: A total of 2,589 human papilloma virus-positive oropharyngeal squamous cell carcinoma patients who underwent surgery were identified from the Surveillance, Epidemiology, and End Results database. Propensity score matching was performed to balance the baseline characteristics between patients who received postoperative radiotherapy and those who did not. Overall survival and disease-specific survival were estimated.

Results: After propensity score matching, postoperative radiotherapy did not increase overall survival and disease-specific survival. The subgroup analysis revealed that overall survival and disease-specific survival benefits of postoperative radiotherapy were observed only among patients with N2 or N3 stage disease. Multivariate analysis revealed that old age and advanced T, N stages were prognostic factors for disease-specific survival in oropharyngeal squamous cell carcinoma patients who underwent surgery.

Conclusion: Postoperative radiotherapy might improve the survival of human papilloma virus-positive oropharyngeal squamous cell carcinoma patients with advanced N stage.