Oral oncology · 2026
The survival benefit of postoperative radiotherapy in pN1 head and neck squamous cell carcinoma without adverse pathological features: analysis of the SEER database.
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Lyu Yi, Chen Lin, Cen Xiaoqing, Deng Yicheng, Lyu Kexing, Lei Wenbin, Fang Ruihua
Аннотация
BACKGROUND: Head and neck squamous cell cancer (HNSCC) patients with pN1, cM0 status without adverse pathological features are associated with a relatively poor prognosis despite a limited metastatic lymph node burden. The survival benefit of postoperative radiotherapy (PORT) for these patients remains uncertain. Therefore, the objective of this study was to evaluate the necessity of PORT in HNSCC patients with pN1, cM0 status and no adverse pathological features by comparing survival outcomes between patients who received PORT and those who did not.
METHOD: The clinical characteristics and follow-up data of HNSCC patients with pN1, cM0 status without adverse pathological features from 2004 to 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were stratified into the PORT and non-PORT groups. Kaplan-Meier analysis was applied to overall survival (OS) and cancer-specific survival (CSS) to evaluate the association of PORT with the clinical outcomes of these patients. Subgroup analysis was performed to identify the subgroup of patients who might benefit from PORT.
RESULTS: Overall, 461 patients were included, with 258 patients who received PORT and 203 patients who did not receive PORT. Patients who received PORT had better OS and CSS than patients who did not receive PORT (5-year OS: 84% vs. 69%, p < 0.001; 5-year CSS: 91% vs. 79%, p < 0.001). According to the subgroup analysis, PORT is associated with a survival benefit in patients with OPSCC and LSCC, who are < 60 years of age, male, single, have grade 1 to 2 tumors, have stage III to IV disease, and undergoing open surgery.
CONCLUSION: This study demonstrated that HNSCC patients with pN1, cM0 status without adverse pathological features were significantly associated with better OS and CSS after receiving PORT. These findings support the use of PORT to achieve improved survival for pN1, cM0 HNSCC patients without adverse pathological features, especially those younger than 60 years of age.
METHOD: The clinical characteristics and follow-up data of HNSCC patients with pN1, cM0 status without adverse pathological features from 2004 to 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were stratified into the PORT and non-PORT groups. Kaplan-Meier analysis was applied to overall survival (OS) and cancer-specific survival (CSS) to evaluate the association of PORT with the clinical outcomes of these patients. Subgroup analysis was performed to identify the subgroup of patients who might benefit from PORT.
RESULTS: Overall, 461 patients were included, with 258 patients who received PORT and 203 patients who did not receive PORT. Patients who received PORT had better OS and CSS than patients who did not receive PORT (5-year OS: 84% vs. 69%, p < 0.001; 5-year CSS: 91% vs. 79%, p < 0.001). According to the subgroup analysis, PORT is associated with a survival benefit in patients with OPSCC and LSCC, who are < 60 years of age, male, single, have grade 1 to 2 tumors, have stage III to IV disease, and undergoing open surgery.
CONCLUSION: This study demonstrated that HNSCC patients with pN1, cM0 status without adverse pathological features were significantly associated with better OS and CSS after receiving PORT. These findings support the use of PORT to achieve improved survival for pN1, cM0 HNSCC patients without adverse pathological features, especially those younger than 60 years of age.