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Stratifying based on pathologic tumor status, neoadjuvant radiation was associated with improved CSS (five-year survival 73.7% vs. 42.1%; P = 0.014) for localized (pT3-4N disease. The Cox multivariate regression analysis revealed that the addition of neoadjuvant radiation for pT3-4N0 diseases with tumor length ≥ 5 cm and squamous cell carcinoma, was a powerful prognostic factor for improved cancer-specific survival (P 0.01). Compared with adjuvant radiotherapy, the addition of neoadjuvant radiation for pT3-4N0 diseases has been as
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