The Benefit of Adjuvant Radiation in Surgically-Treated T1-2 N1 Oropharyngeal Squamous Cell Carcinoma.

IMPORTANCE

The benefit of adjuvant radiation in surgically treated T1-2N1 oropharyngeal cancer without adverse pathologic features remains unclear.

OBJECTIVES

To compare population-level survival outcomes in surgically-treated T1-2N1 oropharyngeal squamous cell carcinoma (OPSCC) with and without the use of adjuvant radiation.

STUDY

DESIGN

Retrospective population-based study using the Surveillance, Epidemiology, and End Results (SEER) registry data from 1998-2011.

SETTING

Population-level study.

PARTICIPANTS

Patients with T1-2N1 OPSCC treated with surgical resection and neck dissection with or without adjuvant radiation.

INTERVENTIONS FOR CLINICAL TRIALS OR EXPOSURES FOR OBSERVATIONAL STUDIES: The use of postoperative adjuvant radiation.

MAIN OUTCOMES AND MEASURES: Overall and disease-specific survival.

RESULTS

Radiation was utilized in 74% of patients and was positively associated with extracapsular extension and well-differentiated histology. The use of radiation was associated with improved mean overall survival (124 v. 108 months, p=0.023) and a non-significant increase in mean disease-specific survival (138 v. 131 months, p=0.053).

CONCLUSIONS AND RELEVANCE: The use of adjuvant radiation is associated with improved survival in surgically-treated T1-2N1 squamous cell carcinoma of the oropharynx with unknown HPV status.

LEVEL OF EVIDENCE: IV.