Author: David Douglas
Postoperative radiotherapy significantly improves survival in patients with early T stage oral cavity squamous cell carcinoma and a single positive lymph node, researchers report in the March issue of Archives of Otolaryngology: Head and Neck Surgery.
“Even for small primary tumors of the oral cavity, the presence of a single positive lymph node may be an indication to offer radiation despite the relatively early stage of these tumors,” lead author Dr. Mark G. Shrime told Reuters Health by email. “This is especially true in T2 tumors of the tongue and the floor of mouth.”
Dr. Shrime of Boston University Medical Center and colleagues examined data on more than 1500 patients who had surgery between 1983 and 2004.
Patients who had postoperative radiotherapy had significantly better 5-year overall survival (54.2% versus 41.4%). The largest advantage was in patients with T2 primary tumors (48.8% versus 32.5%). The difference in patients with T1 tumors (63.4% versus 56.5%) was not statistically significant.
Also, the authors report, adjuvant radiotherapy was particularly effective in T2 tumors of the tongue (improving 5-year survival from 37.9% to 52.3%) and floor of the mouth (boosting survival from 17.7% to 39.9%). For all other sites, adjuvant radiotherapy was not associated with improved overall 5-year survival.
The 5-year cause-specific survival rate was 64.3% in patients treated with surgery alone, versus 72.1% in patients who also had radiotherapy.
While the results appear encouraging, the researchers call for “further analysis with either large multi-institutional series or more detailed population-based registries…with other prognostic pathologic factors controlled for.”
Source: Arch Otolaryngol Head Neck Surg 2010;136:225-228.