After complete resection of a parotid or submandibular adenoid cystic carcinoma, does postoperative radiation help patients live longer? In this episode, we look at an updated National Cancer Database analysis from Memorial Sloan Kettering of 2,384 patients treated between 2004 and 2021.
Postoperative radiation was associated with better 8-year overall survival: 76.9 percent against 70.3 percent, with an adjusted hazard ratio of 0.76. The benefit extended to early-stage and margin-negative disease. The exception was pT3 to 4 tumours with positive margins, where radiation was not associated with better survival. This may be a biologically aggressive group that needs more than local treatment.
We also discuss what the database cannot tell us, including local control and cancer-specific survival, and what these findings mean for tumour board decisions.
In this episode:
- Study design and patient selection
- Survival by tumour stage and margin status
- The pT3 to 4 margin-positive subgroup
- Limitations of registry data
- Bottom line for clinical practice
Source paper:
Chadha N, Ashji G, Ramanan S, Dee EC, et al. Adjuvant radiation for major salivary gland adenoid cystic carcinoma in the modern era: updated patterns of care and survival from the National Cancer Database (2004 to 2021). Oral Oncology. 2026;181:108107.
https://doi.org/10.1016/j.oraloncology.2026.108107Host: Krishnakumar Thankappan
Head and Neck Oncology Journal Club