title: Value of postoperative radiation therapy for regional control after dissection in head and neck squamous cell carcinoma cases.
abstract: OBJECTIVE
  We aimed to define clinicopathologic risk factors associated with regional recurrence (RR) and thus the effectiveness of postoperative radiotherapy (PORT) for neck control for head and neck squamous cell carcinomas (HNSCCs) with differing cervical lymph node status.
  
  
  METHODS
  A retrospective study was performed in 196 HNSCC patients with pathologically positive neck node (N+) to evaluate the high-risk factors for RR and to define the role of PORT in control after neck dissection and postoperative radiotherapy (PORT).
  
  
  RESULTS
  Overall, the RR rate after neck dissection and PORT was 29%. Extracapsular spread (ECS) was confirmed to be the only independent risk factor for RR. There were no significant risk factors associated with RR in the ECS- group. The 5-year disease-specific survival rate was 45%, which descended to 10% with the emergence of RR.
  
  
  CONCLUSIONS
  ECS remains a determined risk factor for RR after neck dissection and PORT in patients with N+. PORT alone is not adequate for preventing RR in the neck with ECS after neck dissection. More intensive postoperative adjuvant therapies, especially combined chemotherapy and radiotherapy, are needed to prevent regional failure in HNSCC patients with ECS.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Bethune International Peace Hospital, Shijiazhuang, China. xmlmo@126.com
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Li
authors.forename: Bin
authors.initials: B
authors.lastname: Di
authors.forename: Yao-Dong
authors.initials: YD
authors.lastname: Shang
authors.forename: Zhen-Feng
authors.initials: ZF
authors.lastname: Tao
authors.forename: Ji-Min
authors.initials: JM
authors.lastname: Cheng
authors.forename: Zhan-Guo
authors.initials: ZG
authors.lastname: He
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000401:mortality*; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D009367:Neoplasm Staging; D011184:Postoperative Period; D011379:Prognosis; D018714:Radiotherapy, Adjuvant / Q000401:mortality*; D012189:Retrospective Studies; D015996:Survival Rate