Value of Postoperative Radiation Therapy for Regional Control after Dissection in Head and Neck Squamous Cell Carcinoma Cases

• Published in: Asian Pacific journal of cancer prevention : APJCP Vol. 14; no. 7; pp. 4273 - 4278
• Main Authors: Li, Xiao-Ming, Di, Bin, Shang, Yao-Dong, Tao, Zhen-Feng, Cheng, Ji-Min, He, Zhan-Guo
• Format: Journal Article
• Language: English
• Published: Thailand 01.01.2013
• Subjects: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - radiotherapy; Carcinoma, Squamous Cell - surgery; Combined Modality Therapy; Female; Follow-Up Studies; Head and Neck Neoplasms - mortality; Head and Neck Neoplasms - radiotherapy; Head and Neck Neoplasms - surgery; Humans; Lymphatic Metastasis; Male; Middle Aged; Neck Dissection - mortality; Neoplasm Invasiveness; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - radiotherapy; Neoplasm Recurrence, Local - surgery; Neoplasm Staging; Postoperative Period; Prognosis; Radiotherapy, Adjuvant - mortality; Retrospective Studies; Survival Rate
• ISSN: 1513-7368; 2476-762X
• DOI: 10.7314/APJCP.2013.14.7.4273

We aimed to define clinicopathologic risk factors associated with regional recurrence (RR) and thus the effectiveness of postoperative radiotherapy (PORT) for neck control for head and neck squamous cell carcinomas (HNSCCs) with differing cervical lymph node status. A retrospective study was performed in 196 HNSCC patients with pathologically positive neck node (N+) to evaluate the high-risk factors for RR and to define the role of PORT in control after neck dissection and postoperative radiotherapy (PORT). Overall, the RR rate after neck dissection and PORT was 29%. Extracapsular spread (ECS) was confirmed to be the only independent risk factor for RR. There were no significant risk factors associated with RR in the ECS- group. The 5-year disease-specific survival rate was 45%, which descended to 10% with the emergence of RR. ECS remains a determined risk factor for RR after neck dissection and PORT in patients with N+. PORT alone is not adequate for preventing RR in the neck with ECS after neck dissection. More intensive postoperative adjuvant therapies, especially combined chemotherapy and radiotherapy, are needed to prevent regional failure in HNSCC patients with ECS.