Adjuvant therapy may be omitted for oral cavity cancer with only one positive lymph node

Wan-Yu Chen; Ku-Hao Fang; Chun-Wei Wang; Chun-Ta Liao; Tzu-Chen Yen; Taun-Jen Fang; Shih-Fan Lai; Hsiang-Kuang Liang; Bing-Shen Huang

doi:10.1002/lio2.679

Adjuvant therapy may be omitted for oral cavity cancer with only one positive lymph node

Laryngoscope Investig Otolaryngol. 2021 Oct 19;6(6):1339-1346. doi: 10.1002/lio2.679. eCollection 2021 Dec.

Authors

Wan-Yu Chen^{1

2

3}, Ku-Hao Fang⁴, Chun-Wei Wang^{1

5

6}, Chun-Ta Liao⁴, Tzu-Chen Yen⁷, Taun-Jen Fang⁴, Shih-Fan Lai^{1

3}, Hsiang-Kuang Liang^{1

3}, Bing-Shen Huang⁸

Affiliations

¹ Division of Radiation Oncology, Department of Oncology National Taiwan University Hospital Taipei Taiwan.
² Graduate Institute of Clinical Medicine National Taiwan University Taipei Taiwan.
³ National Taiwan University Cancer Center Taipei Taiwan.
⁴ Department of Otorhinolaryngology, Head and Neck Surgery Linkou Chang Gung Memorial Hospital and Chang Gung University Taoyuan Taiwan.
⁵ Cancer Research Center National Taiwan University College of Medicine Taipei Taiwan.
⁶ Department of Radiology, College of Medicine National Taiwan University Taipei Taiwan.
⁷ Department of Nuclear Medicine and Molecular Imaging Center Linkou Chang Gung Memorial Hospital and Chang Gung University Taoyuan Taiwan.
⁸ Department of Radiation Oncology Chang Gung Memorial Hospital and Chang Gung University Taoyuan Taiwan.

Abstract

Objective: Whether to administer adjuvant treatment is a matter of great debate for oral cavity cancer harboring a single positive node without extranodal extension and positive margin (defined as low/intermediate risk pN1_new in this study).

Methods: A total of 243 low/intermediate risk pN1_new patients with oral cavity cancer who received curative surgery were included. Overall survival (OS), local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), and distant metastasis-free survival (DMFS) were compared between patients receiving adjuvant treatment and observation alone.

Results: For patients receiving adjuvant therapy vs observation, the differences in outcomes were not statistically significant in terms of 5-year OS, LRFS, RRFS, and DMFS. For subgroup analysis, in low/intermediate pN1_new patients with one or more minor risk factors, adjuvant therapy was not significantly associated with OS, LRFS, RRFS, or DMFS in pN1_new patients.

Conclusion: For low/intermediate risk pN1_new patients with oral cavity cancer, adjuvant therapy might be omitted.

Level of evidence: 4.

Keywords: adjuvant radiotherapy; oral cancer; risk factor; single node; surgery.