Impact of Adjuvant Radiotherapy on Recurrence Outcomes in pT2N0 Oral Squamous Cell Carcinoma: A Propensity Score-Matched Survival Analysis.

Nemade, Hemant; Thaduri, Abhinav; Gondi, Jonathan T; Chava, Sravan Kumar; Akula, Anil Kumar; Konkimalla, Abhilash; Fonseca, Daphne; Arya, Sahithi Shilpa et al. · Head Neck · 2026

retrospective_cohort · Level III

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Abstract

The benefit of adjuvant radiotherapy in pT2N0 oral squamous cell carcinoma (OSCC) remains uncertain. We evaluated its impact on disease-free survival (DFS) using propensity score matching. Patients with pT2N0 OSCC treated between 2015 and 2023 were identified from a prospectively maintained database. One-to-one nearest-neighbor propensity score matching was performed using age, tumor size, depth of invasion, perineural invasion, lymphovascular invasion, margin distance, tumor subsite, histological grade, and bilateral neck dissection status. Three-year DFS was analyzed using Kaplan-Meier methods and Cox regression. Among 400 eligible patients, 226 underwent surgery alone, and 174 received adjuvant radiotherapy. Propensity score matching generated 107 matched pairs. Three-year DFS was 78.3% for surgery alone and 82.1% for surgery plus radiotherapy (p = 0.41). Adjuvant radiotherapy was not associated with improved DFS (HR 0.81, 95% CI 0.48-1.30; p = 0.43). In this propensity score-matched cohort, adjuvant radiotherapy was not associated with improved 3-year DFS in pT2N0 OSCC.