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The overlap propensity score weighting method was applied to account for known confounding. Cox regression analysis and weighted cox regression analysis were used to calculate the hazard ratio (HR) and 95% confidence interval (CI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 247 patients with p16-negative OPSCC (median follow-up duration: 39\u2009months; 3-year OS: 84.9%; 3-year DSS: 89.5%) and 1175 patients with p16-positive OPSCC (median follow-up duration: 35\u2009months; 3-year OS: 95.3%; 3-year DSS: 96.7%) were included. Adjuvant radiotherapy was associated with improved OS [weighted HR (95% CI): 0.37 (0.17-0.79)] and DSS [weighted HR (95% CI): 0.34 (0.13-0.88)] in pT1-2N1-2b p16-negative OPSCC. No prognostic role of adjuvant radiotherapy was observed in pN1 subgroup of p16-negative OPSCC [weighted HR (95% CI) for OS: 0.89 (0.20-4.06); weighted HR (95% CI) for DSS: 1.12 (0.19-6.71)]. Adjuvant radiotherapy was associated with improved OS [weighted HR (95% CI): 0.34 (0.18-0.62)] and DSS [weighted HR (95% CI): 0.30 (0.14-0.64)] in pT1-2N1-2b p16-positive OPSCC. Subgroup analyses of p16-positive OPSCC, including pN1, pN2a-2b, and positive lymph nodes \u22644 subgroups, supported that adjuvant radiotherapy had positive prognostic role.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>Consistent with the National Comprehensive Cancer Network guidelines, patients with pT1-2N2a-2b OPSCC should receive adjuvant radiotherapy (regardless of p16 status), while patients with pT1-2N1 p16-negative OPSCC could consider omitting adjuvant radiotherapy. Patients with pT1-2N1 p16-positive OPSCC may benefit from adjuvant radiotherapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19160216251406522","type":"journal-article","created":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T09:21:12Z","timestamp":1766222472000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic Role of Adjuvant Radiotherapy in Patients With pT1-2N1-2b Oropharyngeal Squamous Cell Carcinoma"],"prefix":"10.1177","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1682-7064","authenticated-orcid":false,"given":"Liang","family":"Peng","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China"},{"name":"Institute of Otolaryngology Head and Neck Surgery, Sun Yat-sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China"},{"name":"Institute of Otolaryngology Head and Neck Surgery, Sun Yat-sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhang-Feng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China"},{"name":"Institute of Otolaryngology Head and Neck Surgery, Sun Yat-sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-Lin","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China"},{"name":"Institute of Otolaryngology Head and Neck Surgery, Sun Yat-sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China"},{"name":"Institute of Otolaryngology Head and Neck Surgery, Sun Yat-sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei-Ping","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China"},{"name":"Institute of Otolaryngology Head and Neck Surgery, Sun Yat-sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-Bin","family":"Lei","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China"},{"name":"Institute of Otolaryngology Head and Neck Surgery, Sun Yat-sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12,20]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2015.61.6995"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23351"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2018.09.018"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9440(10)63871-0"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21389"},{"key":"e_1_3_2_7_2","unstructured":"National Comprehensive Cancer Network. 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