The prognostic factors for a postoperative case vary in effect. Microscopic positive margins and extra capsular spread are high-risk factors. For a case with two or more recurrent risk factors (except a high-risk factor), postoperative radiotherapy is recommended. With postoperative radiotherapy, the survival rate improves approximately 10% or more. When a high-risk factor is found, we need high doses through postoperative radiotherapy. Also, a period of less than eight weeks is desirable for starting postoperative radiotherapy after surgery. There should not be an interval in the radiotherapy. From the results of the recent clinical trial, the standard treatment for a postoperative high-risk case is chemoradiotherapy. The extra effect of the combination anticancer drug is considered to be approximately 10%.
If chemoradiotherapy is used after surgery, it places a large burden on the patient. Therefore, we must properly choose the subjects for postoperative chemoradiotherapy. It will be carried out after the merits have been clearly understood. Since we provide postoperative treatment, we should aim at completing the process and must be careful with drug withdrawal and reduction.