gms | German Medical Science

Objectives: To assess the efficacy of postoperative radiotherapy for the treatment of patients with pathological N1 neck disease.

Study Design: Retrospective unicenter study.

Methods: Review of 118 consecutive patients with squamous cell carcinoma of the upper aerodigestive tract who were initially treated with curative surgery for both the primary tumor and the neck between August 1986 and December 2002 and who were found to have pN1 disease without extracapsular spread. Postoperative radiotherapy was given to 46 patients (39.0%). Time to recurrence in the neck alone as well as time to death of any cause were analyzed with the Kaplan-Meier method.

Results: A total of 8 isolated regional recurrences were observed, 3 of which occurred in contralateral undissected necks. Seven of the 72 patients treated with surgery alone and 1 of the 46 who received postoperative radiotherapy were affected. The respective 3-year neck recurrence rates amounted to 11.9% and 2.9% (P =0.0683). A survival benefit of irradiated patients could not be established which may be due to a significant disparity of treatment groups with regard to pT category (P =0.027).

Conclusions: The data of the present study reveal an improved regional control of pN1 disease if postoperative radiotherapy is applied. This confirms a trend already suggested in the literature. It is still unclear, however, whether survival of the patients will also be increased. This question remains to be resolved in a prospective randomized trial.