POSTOPERATIVE RADIOTHERAPY IMPROVES SURVIVAL IN SQUAMOUS-CELL CARCINOMA OF THE HYPOPHARYNX

BACKGROUND: Postoperative radiation is considered to be ''standard of care'' therapy for advanced, resectable squamous cell carcinoma of the head and neck. This approach has been supported by retrospective data but has not been validated in randomized clinical trials. PATIENTS AN D METHODS: The present analysis examined the clinical course of 110 pa tients with squamous cell cancer of the hypopharynx treated with surge ry alone (n = 65) and postoperative radiotherapy alone (n = 45) betwee n 1966 and 1990. Staging of patients was performed using the 1988 Amer ican Joint Committee on Cancer criteria. Cox regression analyses ident ified clinical and pathologic factors that were significant for diseas e-free and overall survival. Crude and adjusted cancer-specific surviv al rates were calculated. RESULTS: The postoperative radiotherapy grou p presented with more advanced disease than the surgery alone group (s tage III and IV combined, 96% versus 77%, P = 0.015). Crude 5-year can cer-specific survival probabilities were 43% for the postoperative the rapy group and 27% for the surgery alone group (P = NS). Adjusted 5-ye ar survival rates, correcting for differences in significant prognosti c variables between groups, were 18% and 48%, respectively, for the su rgery and postoperative radiotherapy groups (P = 0.029). CONCLUSIONS: The addition of postoperative radiotherapy was associated with improve d disease-free and adjusted overall cancer-specific survival in patien ts with advanced hypopharyngeal squamous cancer. The potential surviva l benefit of postoperative radiotherapy should be addressed in a rando mized clinical trial.