PROGNOSTIC FACTORS IN PATIENTS WITH HEAD-AND-NECK CANCER RECEIVING POSTOPERATIVE RADIOTHERAPY

Sixty patients with locally advanced squamous cell carcinomas of oral cavity, oropharynx, hypopharynx, and larynx were treated with combined therapy of radical surgery and post-operative radiotherapy. Indications for post-operative radiotherapy were pathological staging of the primary tumour (pT3 or pT4), poorly differentiated or undifferentiated carcinoma, tumour invasion in the surrounding tissues, perineural spread, lymphatic and vascular invasion positive neck nodes or extranodal spread, and microscopically positive surgical margins. The contribution for prognosis of these indications for post-operative radiotherapy were retrospectively evaluated univariate and multivariate analysis. Of all investigated parameters, nodal status and lymphatic and vascular invasion were independent prognostic factors. If these unfavourable prognostic signs are present, post-operative radiotherapy has to be intensified to at least curative doses of 60 Gy or more to the areas at risk.