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Ching-Chih Lee
Kaohsiung Veterans General Hospital
Corresponding Author
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Background: To assess the benefit of postoperative radiotherapy in patients with pT1-2N1M0 oral and oropharyngeal cancer by the quality of neck dissection.
Methods: In the Surveillance, Epidemiology, and End Results database, pT1-2N1M0 oral and oropharyngeal cancer patients treated by primary tumor resection and neck dissection with or without radiotherapy were enrolled between 2004 and 2015. Univariate and multivariate analysis were used to explore the effect of adjuvant radiotherapy on 5-year overall survival (OS) and disease-specific survival(DSS).
Results: Of the 1,765 patients identified, 1,108 (62.8%) had oral cancer, 1,141 (64.6%) were men, and 1,067 (60.5%) underwent adjuvant radiotherapy. After adjusting for confounding factors, postoperative radiotherapy reduced the adjusted hazard ratio (aHR) of 5-year OS to 0.64 (95% confidence interval[CI], 0.49-0.84) in those with <18 lymph nodes removed, but not in those with 19-24 lymph nodes removed (aHR, 0.78 ; 95% CI, 0.73-1.13), and in those with >25 lymph nodes removed (aHR, 0.96; 95% CI, 0.75-1.24). For 5-year DSS, similar effect was observed. The adjusted hazard ratio was 0.66 (95% confidence interval, 0.45-0.97) in those with <18 lymph nodes. The protective effect was not seen in those with 18-24 lymph nodes (aHR, 1.07; 95% CI 0.59-1.96), and in those with >25 lymph nodes (aHR, 1.12; 95% CI, 0.81-1.56). Sensitivity testing also showed a robust protective effect of postoperative radiotherapy in patients with <18 lymph nodes removed.
Conclusion: Radiotherapy significantly improved survival in patients with pT1-2N1M0 oral and oropharyngeal cancer without adequate neck dissection.
Keywords
Oral cancer, Oropharyngeal cancer, Radiotherapy, Neck dissection, Survival
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CURRENT STATUS: Published
View the published article at Radiation Oncology.
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Posted 22 Sep, 2020
No community comments so far
Review #3 received
Received 14 Oct, 2020
Editorial decision: Major revision
On 14 Oct, 2020
Review #2 received
Received 05 Oct, 2020
Reviewer #3 agreed
On 28 Sep, 2020
Review #1 received
Received 26 Sep, 2020
Reviewers invited
Invitations sent on 23 Sep, 2020
Reviewer #1 agreed
On 23 Sep, 2020
Reviewer #2 agreed
On 23 Sep, 2020
Editor assigned
On 13 Sep, 2020
Submission checks complete
On 12 Sep, 2020
Editor invited
On 12 Sep, 2020
First submitted
On 11 Sep, 2020
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Subject Areas
Oncology
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See the published version of this preprint at Radiation Oncology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Ching-Chih Lee
Kaohsiung Veterans General Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Radiation Oncology.
Version 1
Posted 22 Sep, 2020
No community comments so far
Review #3 received
Received 14 Oct, 2020
Editorial decision: Major revision
On 14 Oct, 2020
Review #2 received
Received 05 Oct, 2020
Reviewer #3 agreed
On 28 Sep, 2020
Review #1 received
Received 26 Sep, 2020
Reviewers invited
Invitations sent on 23 Sep, 2020
Reviewer #1 agreed
On 23 Sep, 2020
Reviewer #2 agreed
On 23 Sep, 2020
Editor assigned
On 13 Sep, 2020
Submission checks complete
On 12 Sep, 2020
Editor invited
On 12 Sep, 2020
First submitted
On 11 Sep, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Oncology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Radiation Oncology.
Background: To assess the benefit of postoperative radiotherapy in patients with pT1-2N1M0 oral and oropharyngeal cancer by the quality of neck dissection.
Methods: In the Surveillance, Epidemiology, and End Results database, pT1-2N1M0 oral and oropharyngeal cancer patients treated by primary tumor resection and neck dissection with or without radiotherapy were enrolled between 2004 and 2015. Univariate and multivariate analysis were used to explore the effect of adjuvant radiotherapy on 5-year overall survival (OS) and disease-specific survival(DSS).
Results: Of the 1,765 patients identified, 1,108 (62.8%) had oral cancer, 1,141 (64.6%) were men, and 1,067 (60.5%) underwent adjuvant radiotherapy. After adjusting for confounding factors, postoperative radiotherapy reduced the adjusted hazard ratio (aHR) of 5-year OS to 0.64 (95% confidence interval[CI], 0.49-0.84) in those with <18 lymph nodes removed, but not in those with 19-24 lymph nodes removed (aHR, 0.78 ; 95% CI, 0.73-1.13), and in those with >25 lymph nodes removed (aHR, 0.96; 95% CI, 0.75-1.24). For 5-year DSS, similar effect was observed. The adjusted hazard ratio was 0.66 (95% confidence interval, 0.45-0.97) in those with <18 lymph nodes. The protective effect was not seen in those with 18-24 lymph nodes (aHR, 1.07; 95% CI 0.59-1.96), and in those with >25 lymph nodes (aHR, 1.12; 95% CI, 0.81-1.56). Sensitivity testing also showed a robust protective effect of postoperative radiotherapy in patients with <18 lymph nodes removed.
Conclusion: Radiotherapy significantly improved survival in patients with pT1-2N1M0 oral and oropharyngeal cancer without adequate neck dissection.
Figure 1
Figure 2
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