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

Abstract

ImportanceThe benefit of adjuvant radiation in surgically treated T1‐2N1 oropharyngeal cancer without adverse pathologic features remains unclearObjectivesTo compare population‐level survival outcomes in surgically‐treated T1‐2N1 oropharyngeal squamous cell carcinoma (OPSCC) with and without the use of adjuvant radiation.Study DesignRetrospective population‐based study using the Surveillance, Epidemiology, and End Results (SEER) registry data from 1998–2011.SettingPopulation‐level study.ParticipantsPatients with T1‐2N1 OPSCC treated with surgical resection and neck dissection with or without adjuvant radiation.Intervention(s) for Clinical Trials or Exposure(s) for observational studiesThe use of postoperative adjuvant radiation.Main Outcome(s) and MeasuresOverall and disease‐specific survival.ResultsRadiation 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 RelevanceThe 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 EvidenceIV