Oral oncology · 2026
Elective neck irradiation does not improve regional control or survival in pT3-T4N0 oral cavity SCC after high-yield neck dissection: A retrospective multicenter analysis.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Koch Noam, Yosefof Eyal, Gleber-Netto Frederico O, Amir Ido, Edri Nofar, Kottukkal Tiffany, Bachar Gideon, Shpitzer Thomas, Yehuda Moshe, Ritter Amit, Najjar Esmat, Kurman Noga, Amit Moran, Yaniv Dan
Аннотация
OBJECTIVES: In pT3-T4 oral cavity squamous cell carcinoma (OCSCC), standard management includes surgical resection with elective neck dissection (END), frequently followed by postoperative radiotherapy (PORT). While PORT is commonly administered for advanced primary tumors, the benefit of elective neck irradiation (ENI) in patients with a pathologically node-negative (pN0) neck after adequate high-yield END remains uncertain. This study evaluated whether ENI improves regional control or overall survival (OS) in this setting.
METHODS: We conducted a retrospective multicenter cohort study of adults with pT3-T4N0 OCSCC treated between 2004 and 2024 at two tertiary referral centers. All patients underwent high-yield END (≥ 18 lymph nodes). Patients were stratified by PORT field: no PORT, PORT to the primary site only, or PORT to the primary site plus ENI. The primary outcome was regional recurrence-free survival (RFS); secondary outcomes included OS. Survival was analyzed using Kaplan-Meier methods and Cox proportional hazards modeling.
RESULTS: A total of 156 patients were included. Over a median follow-up of 91 months, regional recurrence occurred in 6.4% of patients. There was no significant difference in RFS between patients who received ENI and those who did not (log-rank p = 0.16), nor in OS (log-rank p = 0.30). Stratification by radiotherapy field revealed no differences in RFS (log-rank p = 0.33) or OS (log-rank p = 0.51). In multivariable analysis, ENI was not independently associated with regional recurrence. Tumor stage (pT3 vs pT4a) did not influence regional control or survival.
CONCLUSIONS: In patients with pT3-T4N0 OCSCC who undergo high-yield END, ENI is not associated with improved regional control or OS. These findings support a selective, risk-adapted PORT strategy that omits routine neck irradiation in appropriately staged patients, potentially reducing treatment-related morbidity without compromising oncologic outcomes. Prospective multicenter studies are warranted to confirm these results.
METHODS: We conducted a retrospective multicenter cohort study of adults with pT3-T4N0 OCSCC treated between 2004 and 2024 at two tertiary referral centers. All patients underwent high-yield END (≥ 18 lymph nodes). Patients were stratified by PORT field: no PORT, PORT to the primary site only, or PORT to the primary site plus ENI. The primary outcome was regional recurrence-free survival (RFS); secondary outcomes included OS. Survival was analyzed using Kaplan-Meier methods and Cox proportional hazards modeling.
RESULTS: A total of 156 patients were included. Over a median follow-up of 91 months, regional recurrence occurred in 6.4% of patients. There was no significant difference in RFS between patients who received ENI and those who did not (log-rank p = 0.16), nor in OS (log-rank p = 0.30). Stratification by radiotherapy field revealed no differences in RFS (log-rank p = 0.33) or OS (log-rank p = 0.51). In multivariable analysis, ENI was not independently associated with regional recurrence. Tumor stage (pT3 vs pT4a) did not influence regional control or survival.
CONCLUSIONS: In patients with pT3-T4N0 OCSCC who undergo high-yield END, ENI is not associated with improved regional control or OS. These findings support a selective, risk-adapted PORT strategy that omits routine neck irradiation in appropriately staged patients, potentially reducing treatment-related morbidity without compromising oncologic outcomes. Prospective multicenter studies are warranted to confirm these results.