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Extent of local invasion and safe resection in cT1–2 tonsil cancer
Author(s) -
Lee Jungbok,
Yoon Nara,
Choi Sung Yong,
Moon Jeonghwan,
Chung Man Ki,
Son YoungIk,
Ko YoungHyeh,
Jeong HanSin,
Baek ChungHwan
Publication year - 2012
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23286
Subject(s) - tonsil , medicine , pathology , cancer , stage (stratigraphy) , biology , paleontology
Background Although intraoral resection of small‐sized tonsil cancer achieves excellent tumor control, the extent of local invasion and adequate safety margin in resection have not been studied. Thus, we aim to determine the extent of local invasion in terms of mucosal spread and deep infiltration in stage T1–2 tonsil cancer. Methods We re‐analyzed the surgical specimens from 49 cT1–2 tonsil cancers. Microscopic tumor cell extension from the tumor gross boundary of specimens was assessed in representative sections of each tumor. We also tested whether local extension correlates with human papilloma virus (HPV) status of tumors. Results The extent of microscopic deep invasion from the gross tumor border was 0.52 ± 0.41 mm, which was significantly less than that of mucosal spread (0.83 ± 0.61 mm, P = 0.01) in cT1–2 tonsil cancer. The microscopic deep invasion correlated with tumor size (rho = 0.703, P < 0.001). We found tumor invasion into superior constrictor muscles in 58.1%, no cases of tumor invasion into the deep fascia. In terms of HPV status (genotyping plus p16 staining), there were no differences in microscopic tumor extension. Conclusion Our detailed pathologic analyses confirm that an oropharyngectomy including the superior constrictor muscle is an oncologically safe procedure for stage T1–2 tonsil cancer. J. Surg. Oncol. 2013;107:469–473. © 2012 Wiley Periodicals, Inc.