Value of Postoperative Radiation Therapy for Regional Control after Dissection in Head and Neck Squamous Cell Carcinoma Cases

Abstract

<br/><b>Objective</b>: We aimed to define clinicopathologic risk factors associated with regional recurrence (RR) andthus the effectiveness of postoperative radiotherapy (PORT) for neck control for head and neck squamous cellcarcinomas (HNSCCs) with differing cervical lymph node status. <br/><b>Methods</b>: A retrospective study was performedin 196 HNSCC patients with pathologically positive neck node (N+) to evaluate the high-risk factors for RR andto define the role of PORT in control after neck dissection and postoperative radiotherapy (PORT). <br/><b>Results</b>:Overall, the RR rate after neck dissection and PORT was 29%. Extracapsular spread (ECS) was confirmedto be the only independent risk factor for RR. There were no significant risk factors associated with RR in theECS- group. The 5-year disease-specific survival rate was 45%, which descended to 10% with the emergence ofRR. <br/><b>Conclusions</b>: ECS remains a determined risk factor for RR after neck dissection and PORT in patients withN+. PORT alone is not adequate for preventing RR in the neck with ECS after neck dissection. More intensivepostoperative adjuvant therapies, especially combined chemotherapy and radiotherapy, are needed to preventregional failure in HNSCC patients with ECS.