Postoperative radiotherapy may not be necessary for locally advanced head and neck squamous cell carcinoma: a case-match multicentre study

BMC Oral Health. 2022 Jun 24;22(1):253. doi: 10.1186/s12903-022-02288-x.

Abstract

Background: Some head and neck cancer surgeons found that many patients with locally advanced head and neck squamous cell carcinoma (LA-HNSCC) without postoperative radiotherapy (PORT) also have a good prognosis. The purpose of this study was to determine the effect of PORT on survival in patients with LA-HNSCC.

Methods: A case-match cohort analysis was performed at two institutions on patients with LA-HNSCC. Patients who received surgery alone were case-matched 1: 1 with patients treated by surgery plus PORT based on pT, pN, tumor subsite etc. RESULTS: 114 patients were matched into 57 pairs, with a median follow-up period of 40.2 months. No difference in overall survival (OS, HR 0.88; 95% CI 0.50-1.58; P = 0.79) or disease-specific survival (DFS, 0.86; 95% CI 0.50-1.50; P = 0.76) was observed with no PORT.

Conclusions: PORT isn't necessary for patients with LA-HNSCC who are treated for the first time as long as the head and neck cancer surgeon adhere to appropriate surgical concepts. The indications of PORT for patients with LA-HNSCC need to be further discussed.

Keywords: Disease-specific survival; Head and neck squamous cell carcinoma; Overall survival; Postoperative radiotherapy; Surgery alone.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carcinoma, Squamous Cell* / pathology
  • Carcinoma, Squamous Cell* / radiotherapy
  • Carcinoma, Squamous Cell* / surgery
  • Cohort Studies
  • Head and Neck Neoplasms* / radiotherapy
  • Head and Neck Neoplasms* / surgery
  • Humans
  • Prognosis
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck