Premium
Advanced‐staged tonsillar squamous carcinoma: Organ preservation versus surgical management of the primary site
Author(s) -
Shirazi Haider Ali,
Sivanandan Ranjiv,
Goode Richard,
Fee Willard E.,
Kaplan Michael J.,
Pinto Harlan A.,
Goffinet Don R.,
Le QuynhThu
Publication year - 2006
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20372
Subject(s) - medicine , radiation therapy , stage (stratigraphy) , basal cell , surgery , chemotherapy , multivariate analysis , primary tumor , carcinoma , oncology , cancer , metastasis , paleontology , biology
Background. Our aim was to review our experience in the management of advanced tonsillar squamous cell carcinoma (SCC) and to compare treatment outcomes between patients treated with and without surgery to the primary site. Methods. The records of 74 patients with advanced‐stage tonsillar SCC were reviewed. The median age at diagnosis was 58 years. Thirty‐eight patients received definitive surgery to the primary site, and 36 were treated with an organ‐preservation approach (OP) using radiotherapy ± chemotherapy. Results. No significant difference in overall survival (OS) or freedom from relapse (FFR) by treatment was found. T classification and N status were significant independent predictors on multivariate analysis for OS and FFR. Major late toxicity was noted in 10 patients in the surgical group and nine in the OP group. Conclusion. Patients treated with OP and primary surgery had comparable OS and FFR. T classification and N status were significant independent predictors for tumor relapse and survival. On the basis of these results, we favor organ‐preservation therapy for patients with advanced‐stage tonsillar SCC. © 2006 Wiley Periodicals, Inc. Head Neck, 2006