A 25-Year Analysis of Veterans Treated for Tonsillar Squamous Cell Carcinoma

Jaber, James J.; Moreira, Jonathan; Canar, W. Jeffrey; Bier‐Laning, Carol M.

doi:10.1001/archoto.2009.164

Cited by 12 publications

(13 citation statements)

References 20 publications

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“…The 5‐year local, regional, and locoregional controls rates were also excellent at 89%, 98%, and 88%, respectively. Table is a summary of studies published in the literature evaluating tonsillar SCC managed by primary surgery, radiation, or both . Some series have reported superior results, but these were primarily on patients with T1 and T2 primaries in which transoral tonsillectomies were carried out .…”

Section: Discussionmentioning

confidence: 99%

“…Before the development of organ‐preservation protocols involving concurrent chemoradiation therapy, surgery followed by radiation therapy (RT) was the mainstay of treatment for patients with tonsillar SCC, with 5‐year disease‐specific survival (DSS) rates ranging from 61% to 75% . Over the past 15 years, improvements in chemoradiation have resulted in excellent locoregional control rates and DSS rates that are comparable to outcome results reported for traditional surgery .…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2014

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2014

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“…Based on this plot, an argument could be made for further study of planned neck dissections in all N+ tonsil patients even in the absence of a residual palpable mass. A 25‐year retrospective review of tonsillar malignancy treatment regimens in a VA setting demonstrated that even after 1997, when 3D conformation radiation therapy became available at this institution and chemotherapy became more prevalently used, patients with advanced tonsillar malignancy who had surgical intervention had an improved disease specific survival and a nonsignificant trend toward improved overall survival, even in those with poor performance status 13. Report of significant improvement in overall survival when tonsillar cancers were treated with surgical resection followed by radiation therapy versus only radiation therapy was also reported by Poulsen;14 however, these patients were not regularly treated with concomitant chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Treatment outcome in the residually positive neck after definitive chemotherapy and irradiation

et al. 2011

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“…In spite of their close proximity tongue base-SCCs, tonsil SCCs and soft palate SCCs have different clinical presentation and treatment outcomes [7]. In particular, tonsil SCCs have significantly better outcome (DSS and DFS) than tongue base SCCs [8]. …”

Section: Reviewmentioning

confidence: 99%

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

Pannone

Santoro

Papagerakis

et al. 2011

Infect Agents Cancer

105

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Cancer statistics report an increased incidence of OSCC and OPSCC around the world. Though improvements in screening and early diagnosis have dramatically reduced the incidence of this neoplasm in recent years, the 5-year-disease-free survival, is still poor, specially for oropharyngeal cancer, despite the great scientific and financial efforts. Recently, several papers showed that HPV may be involved at least in the pathogenesis of a subgroup of oral and cervical SCC, leading to distinct molecular characteristics compared with HPV-negative ones. Nevertheless, OPSCCs associated with HPV infection seem to show a better prognosis and affect younger patients (< 40 yrs.), especially females. Therefore, there is the need to properly assess oropharyngeal SCC subgroups: 1) not HPV associated/classic oral SCC: less responsive to anticancer drugs: needs novel post-surgical treatment; 2) HPV associated/oral SCC: needs several management options and suitable "target" therapy against the virus, and/or immune-stimulating therapy. Further issues are: 1) the disclosure of putative targets for more efficient molecular therapy, which may work as cervical cancer post-surgical treatment, in anticipation of the effects of "global prevention" performed by WHO anti-HPV vaccination programs; 2) careful identification of precancerous lesions in both sites; dysplasia is currently treated by excisional or ablative procedures, which don't consider the concept of field carcinogenesis. In fact, it is probable that near or far from an excised precancerous lesion new foci of cell transformation may exist, which are not yet macroscopically evident, but, if detected, would put the patient into a high risk subgroup.Comparing findings reported in the recent literature, the data of this state of the art about HPV might add useful informations concerning oropharyngeal carcinogenesis. Moreover, our review would be useful in order to define novel perspectives of treatment choice for Head & Neck cancer patients, by combining well known chemotherapeutical drugs with new molecular "target" therapy.

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A 25-Year Analysis of Veterans Treated for Tonsillar Squamous Cell Carcinoma

Abstract: 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.

Cited by 12 publications

References 20 publications

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

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

Treatment outcome in the residually positive neck after definitive chemotherapy and irradiation

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

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