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Variation in use of postoperative chemoradiation following surgery for T1 and T2 oropharyngeal squamous cell carcinoma; National Cancer Database
Author(s) -
Roman Benjamin R.,
Baxi Shrujal S.,
Cracchiolo Jennifer R.,
Blackwell Timothy J.,
Pfister David G.,
McBride Sean,
Ganly Ian,
Shah Jatin P.,
Patel Snehal G.,
Morris Luc G.,
Cohen Marc A.
Publication year - 2017
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24674
Subject(s) - medicine , basal cell , cancer , surgery , database , computer science
Background and Objectives Primary surgical treatment of patients with early T‐classification (T1‐T2) oropharyngeal squamous cell carcinoma (OPSCC) has increased. We sought to determine how often these patients receive postoperative chemoradiation (CRT). Methods Patients with T1‐T2 OPSCC in the National Cancer Database who underwent primary surgery were evaluated for receipt of postoperative CRT. Postoperative CRT use was examined among patients with high risk factors (positive margins and/or extracapsular spread [ECS]), intermediate risk factors (negative margins, no ECS, and either pT3‐4 and/or N2‐N3), and no apparent risk factors. Results Of 4833 patients with T1‐T2 OPSCC who underwent primary surgery, 43% had high risk pathologic factors, of whom only 63% received postoperative CRT. Another 31% had no apparent risk factors, of whom 16% nonetheless received postoperative CRT. On multivariable analysis, in addition to tumor and demographic factors, patients treated at community hospitals were more likely to receive postoperative CRT (O.R. 1.41 C.I. 1.18‐1.87, P = 0.001). Conclusions Variation in postoperative CRT use indicates a lack of consensus and/or knowledge about its benefits and indications. Usage of postoperative CRT regardless of pathologic risk factors suggests an area where future efforts at implementation of best practices may be targeted.