Synergistic predictive value of T-stage and lymph node yield in guiding adjuvant radiotherapy decisions for pN1 OSCC without high-risk features: a multi-institutional retrospective cohort study.

Bo Li, Yu Huang, Hanchen Zhou, Chuanbin Guo, Wei Wei, Wei Cao, Zhien Feng

Abstract readMulticenter Study

In one paragraph

Article in Clinical oral investigations, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Bo LiDepartment of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100070, P.R. China.

Yu HuangDepartment of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100070, P.R. China.

Hanchen ZhouDepartment of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100070, P.R. China.

Chuanbin GuoDepartment of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, P.R. China.

Wei WeiClinical Epidemiology and EBM Unit, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, PR China.

Wei CaoDepartment of Oral and Maxillofacial & Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, P.R. China. caowei561521@shsmu.edu.cn.

Zhien FengDepartment of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100070, P.R. China. jyfzhen@mail.ccmu.edu.cn.

Funding

National Natural Science Foundation of China 82573934Young Scientist Program of Beijing Stomatological Hospital, Capital Medical University YSP202310

6 · The paper itself

Abstract

objectivesThis study aimed to identify a subset of patients with pN1 oral squamous cell carcinoma (OSCC) and no adverse pathological features who derive significant benefit from adjuvant radiotherapy (RT). MATERIALS AND

methodsIn this multicenter retrospective study, 232 eligible pN1 OSCC patients were analyzed. Patients were stratified by T-stage (T1-2 vs. T3-4) and lymph node yield (LNY; high: ≥20; low: <20). The impact of adjuvant RT on survival outcomes was evaluated.

resultsA significant survival benefit from adjuvant RT was observed exclusively in the subgroup with advanced T-stage (T3-4) and low LNY (< 20), with improved disease-free survival (69.2% vs. 23.1%, p = 0.003), overall survival (76.9% vs. 38.5%, p = 0.012), and disease-specific survival (80.8% vs. 46.2%, p = 0.014). In contrast, no significant survival differences were found in the other T-stage/LNY subgroups. Furthermore, LNY alone did not independently predict prognosis or RT benefit in the overall cohort.

conclusionsThis retrospective study suggests that pN1 OSCC patients with T3-4a stage disease and a low LNY (LNY < 20, levels I-III) may represent a subgroup that derives benefit from adjuvant RT. These exploratory findings suggest a practical model that warrants prospective validation to guide personalized therapy. CLINICAL RELEVANCE: This study provides clinical evidence to help refine the postoperative management of pN1 OSCC patients without high-risk features. It provides a practical stratification tool to guide personalized treatment decisions, aiming to optimize survival outcomes while reducing unnecessary radiotherapy.

Indexed as

Carcinoma, Squamous CellMouth NeoplasmsAgedFemaleHumansLymphatic MetastasisLymph NodesMaleMiddle AgedNeoplasm StagingPredictive Value of TestsPrognosisRadiotherapy, AdjuvantRetrospective StudiesSurvival RateLymph node yieldOSCCpN1RadiotherapyT-stage

Identifiers

PMID42068453

DOI10.1007/s00784-026-06894-9

What OpenQuestion holds

Textmetadata

Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.