Adjuvant therapy may be omitted for oral cavity cancer with only one positive lymph node

OBJECTIVE: Whether to administer adjuvant treatment is a matter of great debate for oral cavity cancer harboring a single positive node without extranodal extension and positive margin (defined as low/intermediate risk pN1(new) in this study). METHODS: A total of 243 low/intermediate risk pN1(new) patients with oral cavity cancer who received curative surgery were included. Overall survival (OS), local recurrence‐free survival (LRFS), regional recurrence‐free survival (RRFS), and distant metastasis‐free survival (DMFS) were compared between patients receiving adjuvant treatment and observation alone. RESULTS: For patients receiving adjuvant therapy vs observation, the differences in outcomes were not statistically significant in terms of 5‐year OS, LRFS, RRFS, and DMFS. For subgroup analysis, in low/intermediate pN1(new) patients with one or more minor risk factors, adjuvant therapy was not significantly associated with OS, LRFS, RRFS, or DMFS in pN1(new) patients. CONCLUSION: For low/intermediate risk pN1(new) patients with oral cavity cancer, adjuvant therapy might be omitted. LEVEL OF EVIDENCE: 4.