title: Precisely defining high-risk operable head and neck tumors based on RTOG #85-03 and #88-24: targets for postoperative radiochemotherapy?
abstract: BACKGROUND
  Local-regional recurrence of disease remains the major obstacle to cure of advanced head and neck cancers.
  
  
  METHODS
  This investigation reviewed data derived from Radiation Therapy Oncology Group (RTOG) protocols #85-03 and #88-24 to identify characteristics of tumors that predicted local-regional recurrence of disease following surgery and postoperative radiotherapy (RT).
  
  
  RESULTS
  The presence of tumor in two or more lymph nodes, and/or extracapsular spread of nodal disease, and/or microscopic-size tumor involvement of the surgical margins of resection imparts a high risk of local-regional (L-R) relapse. Our data also support the hypothesis that, following surgery, the concurrent addition of chemotherapy (CT) to RT may increase the likelihood of L-R control of disease for patients who have these high-risk characteristics.
  
  
  CONCLUSIONS
  A prospective trial of surgery followed by concurrent RT and CT is warranted for patients who have high-risk characteristics found at surgery.
authors.affiliation: Department of Radiation Oncology, NYU Medical Center, New York 10016, USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Cooper
authors.forename: T F
authors.initials: TF
authors.lastname: Pajak
authors.forename: A
authors.initials: A
authors.lastname: Forastiere
authors.forename: J
authors.initials: J
authors.lastname: Jacobs
authors.forename: K K
authors.initials: KK
authors.lastname: Fu
authors.forename: K K
authors.initials: KK
authors.lastname: Ang
authors.forename: G E
authors.initials: GE
authors.lastname: Laramore
authors.forename: M
authors.initials: M
authors.lastname: Al-Sarraf
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D016019:Survival Analysis; D016896:Treatment Outcome