Affiliation:
1. Department of Otolaryngology‐Head and Neck Surgery NYU Langone Health New York New York USA
2. Department of Population Health NYU Langone Health New York New York USA
3. Department of Radiation Oncology NYU Langone Health New York New York USA
4. Head & Neck Service Memorial Sloan Kettering Cancer Center New York New York USA
Abstract
ObjectiveTo investigate the impact of adjuvant radiotherapy in isolated locally advanced oral cavity cancers (pT3N0M0) without adverse features.MethodsWe selected all patients from the National Cancer Database (2004–2019) who underwent surgical treatment where the final pathology was T3N0M0 with negative margins. Demographics, details of treatment, and outcomes were abstracted. The impact of radiotherapy on survival was assessed with univariable, multivariable, and propensity score‐matched analyses.ResultsWe identified 571 patients in our survival cohort. Most were male (348, 60.9%), and median age was 65. Less than one‐third (176, 30.8%) received adjuvant radiotherapy. The median length of follow‐up was 29 months. Overall, adjuvant radiotherapy was associated with improved survival (87.2% vs. 77.7%, at 2 years, p < 0.01). On multivariable analysis controlling for age and comorbidities, this survival difference persisted (HR: 0.62, 95% CI: 0.43–0.90, p = 0.01). In a propensity score‐matched population of 278 patients matched on age and comorbidities, adjuvant radiotherapy was still associated with longer survival (87.4% vs. 78.5%, p = 0.014).ConclusionIn our study, adjuvant radiotherapy was associated with improved survival in completely excised locally advanced oral cavity tumors (T3N0M0). However, a significant proportion of patients do not receive adjuvant radiotherapy. These findings highlight the need for continued efforts to promote guideline‐recommended care.Level of EvidenceLevel 3 Laryngoscope, 2023