Postoperative radiotherapy in patients with positive nodes after functional neck dissection

A study was designed to assess the usefulness of postoperative radiotherapy (RT) in patients with surgically treated laryngeal and hypopharyngeal canc er with histologically proven positive neck nodes. Patients underwent opera tion between 1984 and 1995, with functional neck dissection (FND) being par t of the treatment in all cases. The selection criteria included squamous c ell carcinoma, negative margins For the primary tumor, and no previous trea tment. For evaluation purposes, patients were divided into 2 groups: surger y alone Versus surgery with postoperative RT. Eighty-three patients fulfill ed the inclusion criteria and entered the study. All but 1 of the patients were men. The mean age was 58 years (range, 35 to 77 years). A multivariate analysis was used to analyze the prognostic parameters selected by univari ate analysis, eg, age, alcohol, tumor location, T and N stages, and presenc e or absence of extracapsular spread and a desmoplastic pattern. Postoperat ive RT was not selected by univariate analysis as a prognostic factor, but was included in the multivariate analysis in order to assess its impact on survival and recurrence rates. Using the statistical method of multivariate analysis, we could not find evidence of a benefit to survival or local rec urrence rates with postoperative RT in this series. Patients younger than 5 5 years and those with extracapsular spread had a decreased survival rate a nd a higher neck recurrence rate, irrespective of the treatment method.