Impact of Adjuvant Radiotherapy on Recurrence Outcomes in pT2N0 Oral Squamous Cell Carcinoma: A Propensity Score–Matched Survival Analysis

Background The benefit of adjuvant radiotherapy in pT2N0 oral squamous cell carcinoma (OSCC) remains uncertain. We evaluated its impact on disease‐free survival (DFS) using propensity score matching. Methods Patients with pT2N0 OSCC treated between 2015 and 2023 were identified from a prospectively maintained database. One‐to‐one nearest‐neighbor propensity score matching was performed using age, tumor size, depth of invasion, perineural invasion, lymphovascular invasion, margin distance, tumor subsite, histological grade, and bilateral neck dissection status. Three‐year DFS was analyzed using Kaplan–Meier methods and Cox regression. Results Among 400 eligible patients, 226 underwent surgery alone, and 174 received adjuvant radiotherapy. Propensity score matching generated 107 matched pairs. Three‐year DFS was 78.3% for surgery alone and 82.1% for surgery plus radiotherapy ( p = 0.41). Adjuvant radiotherapy was not associated with improved DFS (HR 0.81, 95% CI 0.48–1.30; p = 0.43). Conclusions In this propensity score–matched cohort, adjuvant radiotherapy was not associated with improved 3‐year DFS in pT2N0 OSCC.