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A Matched-Pair Analysis of the Role of Combined Surgery and Postoperative Radiotherapy

John G. Armstrong, MB, MRCPI; Louis B. Harrison, MD; Ronald H. Spiro, MD; Daniel E. Fass, MD; Elliot W. Strong, MD; Zvi Y. Fuks, MD

Arch Otolaryngol Head Neck Surg. 1990;116(3):290-293.

Abstract
• Between 1966 and 1982, 46 patients with previously untreated malignant tumors of major salivary gland origin received combined surgery and postoperative radiotherapy. They were compared with 46 patients treated with surgery only between 1939 and 1965, who were matched according to prognostic criteria. Radiation doses ranged from 4000 to 7740 cGy (median, 5664 cGy). The 5-year determinate survival rates for patients given combined therapy with stage I and II disease vs patients given surgery only was 81.9% vs 95.8%, while for stages III and IV it was 51.2% vs 9.5%, respectively. Local control for stage III and IV disease in patients given combined therapy vs patients given surgery only at 5 years was 51.3% vs 16.8%. For patients with nodal metastases, 5-year determinate survival for the combined-therapy group vs the surgery-only group was 48.9% vs 18.7%, and the corresponding local-regional control was 69.1% vs 40.2%. The results of this analysis suggest that postoperative radiotherapy significantly improves outcome for patients with stage III and IV disease and for patients with lymph node metastases.

(Arch Otolaryngol Head Neck Surg. 1990;116:290-293)

Author Affiliations
From the Department of Radiation Oncology (Drs Armstrong, Harrison, Fass, and Fuks) and the Head and Neck Service (Drs Spiro and Strong), Memorial Sloan-Kettering Cancer Center, New York, NY.

Footnotes
Accepted for publication September 19, 1989.

Read before the 30th Annual Meeting of the American Society for Therapeutic Radiology and Oncology, New Orleans, La, October 12, 1988.

Reprint requests to Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021 (Dr Harrison).

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