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This study aimed to examine the high\u2010risk factors of postoperative tumor recurrence after surgical resection of HSCC and devise individualized postoperative adjuvant treatment (POAT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Overall, 218 patients with stage IVa\u2010b HSCC who received surgery as initial treatment and with negative surgical margins were evaluated. Independent risk factors of recurrence were identified, and survival outcomes were compared according to recurrence risk and POAT use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>POAT significantly improved recurrence\u2010free survival (RFS) and overall survival (OS) only in the high\u2010risk patients (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.003 and 0.018, respectively). Compared with postoperative radiotherapy alone, postoperative chemoradiotherapy (pCRT) achieved significantly better RFS (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.035) and OS (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.048).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>POATs are recommended for high\u2010risk patients with stage Iva\u2010b HSCC, with pCRT achieving superior outcomes. Regular re\u2010examination after tumor resection is sufficient for low\u2010risk patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.27074","type":"journal-article","created":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T05:50:49Z","timestamp":1659419449000},"page":"2030-2039","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Recurrence risk stratification and treatment strategies of patients with stage <scp>IVa<\/scp>\u2010b hypopharyngeal squamous cell carcinoma"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5625-8324","authenticated-orcid":false,"given":"Yu","family":"Heng","sequence":"first","affiliation":[{"name":"ENT Institute and Department of Otorhinolaryngology Eye &amp; ENT Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengzhi","family":"Xu","sequence":"additional","affiliation":[{"name":"ENT Institute and Department of Otorhinolaryngology Eye &amp; ENT Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3323-1828","authenticated-orcid":false,"given":"Hanqing","family":"Lin","sequence":"additional","affiliation":[{"name":"ENT Institute and Department of Otorhinolaryngology Eye &amp; ENT Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoke","family":"Zhu","sequence":"additional","affiliation":[{"name":"ENT Institute and Department of Otorhinolaryngology Eye &amp; ENT Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8588-2959","authenticated-orcid":false,"given":"Liang","family":"Zhou","sequence":"additional","affiliation":[{"name":"ENT Institute and Department of Otorhinolaryngology Eye &amp; ENT Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Zhang","sequence":"additional","affiliation":[{"name":"ENT Institute and Department of Otorhinolaryngology Eye &amp; ENT Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji","family":"Li","sequence":"additional","affiliation":[{"name":"ENT Institute and Department of Otorhinolaryngology Eye &amp; ENT Hospital, Fudan University  Shanghai China"},{"name":"Department of Radiation Oncology Eye &amp; ENT Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3384-9396","authenticated-orcid":false,"given":"Lei","family":"Tao","sequence":"additional","affiliation":[{"name":"ENT Institute and Department of Otorhinolaryngology Eye &amp; ENT Hospital, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2018.09.025"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-011-1694-8"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-017-4766-6"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-020-03337-0"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24915"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e318173dc4a"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-010-0985-4"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.21873\/anticanres.12626"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2019.00419"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2013.0113"},{"key":"e_1_2_9_12_1","unstructured":"National Comprehensive Cancer Network (NCCN).Clinical Practice Guidelines in Oncology. 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