Squamous cell carcinoma of the tonsil managed by conventional surgery and postoperative radiation

Head Neck. 2015 Jun;37(6):800-7. doi: 10.1002/hed.23679. Epub 2014 Jun 19.

Abstract

Background: The purpose of this study was to report the long-term outcome of patients with squamous cell cancer (SCC) of the tonsil managed by surgery followed by postoperative radiotherapy (PORT).

Methods: Eighty-eight patients treated between 1985 and 2005 were analyzed. Overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) were determined by the Kaplan-Meier method. Factors predictive of outcome were determined by univariate and multivariate analysis.

Results: Forty-eight percent of patients had T3 to T4 disease and 75% had a positive neck. Five-year OS, DSS, and RFS were 66%, 82%, and 80%, respectively. The status of the neck was not predictive of outcome (DSS 80% for N0 vs 82% for N+; p = .97). Lymphovascular invasion was an independent predictor of OS, DSS, and RFS on multivariate analysis.

Conclusion: Lymphovascular invasion but not pathological stage of the neck is an independent predictor of outcome in patients with tonsillar SCC.

Keywords: human papillomavirus (HPV); oropharynx; prognostic factors; squamous cell carcinoma (SCC); surgery; tonsil.

MeSH terms

  • Analysis of Variance
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / radiotherapy*
  • Carcinoma, Squamous Cell / surgery*
  • Cohort Studies
  • Confidence Intervals
  • Disease-Free Survival
  • Female
  • Humans
  • Lymph Nodes / pathology
  • Lymph Nodes / surgery
  • Male
  • Multivariate Analysis
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Prognosis
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis
  • Tonsillar Neoplasms / mortality
  • Tonsillar Neoplasms / pathology
  • Tonsillar Neoplasms / radiotherapy*
  • Tonsillar Neoplasms / surgery*
  • Tonsillectomy / methods*
  • Treatment Outcome