Literature DB >> 19917929

A 25-year analysis of veterans treated for tonsillar squamous cell carcinoma.

James J Jaber1, Jonathan Moreira, W Jeffrey Canar, Carol M Bier-Laning.   

Abstract

OBJECTIVE: To determine the recurrence and survival outcome based on treatment date, type of treatment, stage of disease, and comorbidity and the recurrence and survival differences based on smoking status as a surrogate for human papillomavirus status in veterans treated for tonsillar squamous cell carcinoma (SCC).
DESIGN: Outcome cohort study.
SETTING: Tertiary care Department of Veterans Affairs hospital. PATIENTS: A consecutive sample from 1981 through 2006 of 683 patients treated for oropharyngeal SCC was screened, and 141 patients with tonsillar SCC without distant metastatic spread and a minimum of 2 years of follow-up were included. MAIN OUTCOME MEASURES: Disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS).
RESULTS: Disease-free survival was significantly better in cohort II (treated during or after 1997) compared with cohort I (treated before 1997) (2- and 5-year DFS, 82% vs 64% and 67% vs 48%; P = .02). Disease-specific survival was better in the surgical vs nonsurgical group (2- and 5-year DSS, 77% vs 46% and 67% vs 30%; P < .001), as was the OS (2- and 5-year OS, 66% vs 41% and 45% vs 23%; P = .005). In subjects with early-stage disease, OS and DSS were not different regardless of treatment type. In subjects with late-stage disease treated most recently (time cohort II), there was significantly better DSS in those receiving surgical vs nonsurgical treatment (2-year DSS, 70% vs 43%; P = .045). Nonsmokers had better OS (94 months vs 41 months; P = .001) and lower incidence of recurrence (8% vs 44%; P = .02).
CONCLUSION: In veterans treated for tonsillar SCC, we advocate the consideration of a treatment plan that includes surgery for patients presenting with advanced-stage SCC of the tonsil, even in patients with notable comorbidities.

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Mesh:

Year:  2009        PMID: 19917929     DOI: 10.1001/archoto.2009.164

Source DB:  PubMed          Journal:  Arch Otolaryngol Head Neck Surg        ISSN: 0886-4470


  3 in total

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

Authors:  Rahmatullah Rahmati; Snjezana Dogan; Owen Pyke; Frank Palmer; Mahmoud Awad; Nancy Lee; Dennis H Kraus; Jatin P Shah; Snehal G Patel; Ian Ganly
Journal:  Head Neck       Date:  2014-06-19       Impact factor: 3.147

2.  Histopathologic predictors of lymph node metastasis and prognosis in tonsillar squamous cell carcinoma.

Authors:  Dong Jin Lee; Mi Jung Kwon; Eun Sook Nam; Ji Hyun Kwon; Jin Hwan Kim; Young-Soo Rho; Hyung Sik Shin; Seong Jin Cho
Journal:  Korean J Pathol       Date:  2013-06-25

3.  The role of human papillomavirus in the pathogenesis of head & neck squamous cell carcinoma: an overview.

Authors:  Giuseppe Pannone; Angela Santoro; Silvana Papagerakis; Lorenzo Lo Muzio; Gaetano De Rosa; Pantaleo Bufo
Journal:  Infect Agent Cancer       Date:  2011-03-29       Impact factor: 2.965

  3 in total

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