Factors influencing the outcomes of primary surgery with postoperative radiotherapy for pN2 oropharyneal squamous cell carcinoma

SummaryThe purpose of this study was to examine treatment outcomes and define factors that influence survival in patients with pN2 oropharyngeal carcinoma. Fifty-five patients underwent primary surgery with postoperative radiotherapy between 1994 and 2009. Primary tumor sites were 36 tonsil, 13 base of tongue, 3 soft palate, and three posterior pharyngeal wall. There were 15, 26, 5, and 9 patients with stage T1 to T4 cancers, respectively. The N stage were 5 N2a, 37 N2b, and 13 N2c. The 5-year disease-specific survival rates were 66%. A significant positive correlation was found between high risk HPV status and extracapsular spread and disease-specific survival rates (HPV (+); 93% vs. HPV (−); 56%, p = 0.031 and extracapsular spread (−); 93% vs. extracapsular spread (+); 50%, p = 0.008, respectively). Primary surgery with postoperative radiotherapy can be achieved with favorable oncologic outcomes for pN2 oropharyngeal carcinoma. Factors that affected prognosis were HPV status and extracapsular spread.