Value of postoperative radiotherapy in patients with pathologic N1 neck disease.

BACKGROUND The aim of this study was to assess the efficacy of postoperative radiotherapy for the treatment of patients with pathologic N1 neck disease. METHODS One hundred eighteen consecutive patients with upper aerodigestive tract cancer who were initially treated with curative surgery between 1986 and 2002 and had pN1 disease without extracapsular spread were reviewed. Postoperative radiotherapy was given to 46 patients. RESULTS Eight isolated regional recurrences were observed, 3 of which occurred in contralateral undissected necks. Seven of the 72 patients treated with surgery alone and 1 of the 46 who received postoperative radiotherapy were affected. The respective 3-year neck recurrence rates amounted to 11.2% and 2.9% (p = .0921). A survival benefit of irradiated patients could not be established. CONCLUSIONS The data confirm a trend toward improved regional control of pN1 disease if postoperative radiotherapy is applied. However, as a survival benefit is uncertain, use of radiation treatment cannot be recommended generally, but requires individual decisions.