Is postoperative adjuvant therapy necessary for pT3N0 oral cavity squamous cell carcinoma?
Journal
Oral oncology
Journal Volume
162
Start Page
Article number 107198
ISSN
1879-0593
Date Issued
2025-03
Author(s)
Hua, Chun-Hung
Lin, Jin-Ching
Wen, Yu-Wen
Kang, Chung-Jan
Lin, Chien-Yu
Ku, Hsiu-Ying
Fan, Kang-Hsing
Ng, Shu-Hang
Lee, Shu-Ru
Tsai, Yao-Te
Chen, Wen-Cheng
Lee, Li-Yu
Chien, Chih-Yen
Che, Tsung-Ming
Terng, Shyuang-Der
Tsai, Chi-Ying
Wang, Hung-Ming
Hsieh, Chia-Hsun
Yeh, Chih-Hua
Lin, Chih-Hung
Tsao, Chung-Kan
Cheng, Nai-Ming
Fang, Tuan-Jen
Huang, Shiang-Fu
Lee, Li-Ang
Fang, Ku-Hao
Wang, Yu-Chien
Lin, Wan-Ni
Hsin, Li-Jen
Yen, Tzu-Chen
Liao, Chun-Ta
Abstract
Background: The current NCCN guidelines advocate for the use of adjuvant radiotherapy (RT) or chemoradiotherapy (CRT) in pT3N0 oral cavity squamous cell carcinoma (OCSCC). Here, we sought to evaluate whether postoperative RT/CRT may confer a survival advantage in pT3N0 patients who lack adverse pathological features. Methods: A dataset of 852 pT3N0 OCSCC patients treated between 2018 and 2021 was analyzed. Patients with adverse pathological features (i.e., positive margins, margins <5 mm, lymphovascular invasion, or perineural invasion) were excluded, leaving 235 eligible patients. The cohort was further refined by omitting 12 patients who received surgery plus chemotherapy and two cases who received RT doses <5000 cGy, resulting in two study groups: surgery alone (n = 131) and surgery plus RT/CRT (n = 90). Results: Baseline characteristics were comparable between groups, except for a higher proportion of buccal subsite (p = 0.0063) and female patients (p = 0.0495) in the surgery alone group. Kaplan-Meier analyses revealed no significant differences in 4-year disease-specific survival (DSS) (84.2 % versus 85.9 %, p = 0.8834) or overall survival (OS) (75.6 % versus 84.8 %, p = 0.2376). These findings were confirmed by multivariable analyses and remained consistent after propensity score matching (n = 74 per group), with similar survival outcomes between groups (4-year DSS, 90.7 % versus 83.2 %, p = 0.4020; 4-year OS, 87.0 % versus 81.9 %, p = 0.6121) Conclusions: For patients with pT3N0 OCSCC lacking adverse pathological features, the addition of adjuvant RT/CRT does not appear to confer a survival benefit over surgery alone.
Subjects
Adjuvant therapy
Oral cavity squamous cell carcinoma
Propensity score matching
Survival outcomes
pT3N0
Type
journal article