Is it necessary to receive radiation for pT3‐4N0 oral cancer without other adverse risk features?

Abstract

Objective The purpose of this study was to explore the necessity of adjuvant radiotherapy for well‐differentiated pT3‐4aN0M0 OSCC without other negative features histologically. Patients and Methods This is a double‐center, ambispective cohort study enrolling 250 patients with well‐differentiated pT3‐4aN0M0 OSCC. Results 250 patients were enrolled in the double‐center study, 155(62.0%) men and 95 (38.0%) women, and the mean age was 60.1 ± 11.1 years. T staging was classified as follows: T3 (n=99, 39.6%), and T4a (n=151, 60.4%). Kaplan‐Meier analysis showed that there was no significant difference in the DSS between patients who received adjuvant radiotherapy (72.2%) and those who did not (77.4%) (p=0.615). Specifically, no significant difference was found in the DSS of pT3N0M0 or pT4aN0M0 patients who received adjuvant radiotherapy compared with those who did not (pT3N0M0: 71.9% vs. 75.8%, p=0.993; pT4aN0M0: 72.4% vs. 78.5%, p=0.491). The Cox proportional hazards regression models showed that no factor was independent prognostic factor for pT3‐4aN0M0 patients, or pT3N0M0 subgroup or pT4aN0M0 subgroup in DSS. And no independent prognostic factor was found for the surgery alone subgroup and adjuvant radiotherapy subgroup. Conclusions The results showed that adjuvant radiotherapy did not obviously improve the prognosis of pT3‐4aN0M0 well‐differentiated OSCC without other negative features.