Should the Contralateral Tonsil Be Removed in Cases of <scp>HPV</scp>‐Positive Squamous Cell Carcinoma of the Tonsil?

Kim, Christine M.; John, Maie A. St.

doi:10.1002/lary.27563

Cited by 9 publications

(12 citation statements)

References 5 publications

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“…10 In 2018, a Triologic Society Best Practice guideline was published that recommended routine bilateral tonsillectomy in patients with known or suspected p16+ squamous cell carcinoma of the tonsil. 11 Some argued that this guideline was not sufficiently substantiated and would only increase morbidity in most patients. 12 Our objective with this study was to systematically review the literature to determine the rate and clinical outcomes of second primary oropharyngeal cancer in patients with an index p16+ OPSCC.…”

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confidence: 99%

Systematic Review of Second Primary Oropharyngeal Cancers in Patients With p16+ Oropharyngeal Cancer

Bollig

Lee

Mazul

et al. 2020

Otolaryngol.--head neck surg.

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Objective To systematically review the literature to determine the prevalence and clinical outcomes of second primary oropharyngeal squamous cell carcinoma (OPSCC). Data Sources Search strategies created with a medical librarian were implemented using multiple databases in October 2019. Review Methods The population of interest included adults age >18 years with a p16+ or human papillomavirus-positive OPSCC. The outcome was a synchronous or metachronous second primary OPSCC. Inclusion and exclusion criteria were designed to capture all study designs. In total, 685 records were identified by the search strategy. Two reviewers independently performed the review, extracted data, and performed a quality assessment. Primary Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A random-effects model was used for the meta-analysis. Results A total of 2470 patients with 35 second primary OPSCCs from 15 studies were identified. The pooled prevalence of second primary OPSCC was 1.4% (range, 0%-14.3%). In the random-effects model, the prevalence was estimated at 1.3% (95% CI, 0.7%-2.3%; P = .51, I2 = 52%). Of the 30 patients with treatment information, 26 (86.7%) received surgical treatment, while 4 (13.3%) underwent nonsurgical therapy. Of the 29 patients with available survival information, 22 (75.9%) had no evidence of disease at last follow-up, 5 (17.2%) ultimately died of disease, and 2 (6.9%) were alive with disease. Conclusion Overall, the rate of second primary OPSCC in patients with an index p16+ OPSCC is low, and most patients are successfully treated. Insufficient evidence currently exists to recommend routine elective tonsillectomy during surgical treatment of p16+ OPSCC.

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confidence: 99%

Systematic Review of Second Primary Oropharyngeal Cancers in Patients With p16+ Oropharyngeal Cancer

Bollig

Lee

Mazul

et al. 2020

Otolaryngol.--head neck surg.

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“…with interest. 1 This addresses an important clinical question that is frequently encountered in practice. The authors reached the conclusion that it is best practice to routinely remove the contralateral tonsil in cases of unilateral human papillomavirus (HPV)-positive tonsillar squamous cell carcinoma (SCC).…”

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confidence: 99%

In Reference to Should the Contralateral Tonsil Be Removed in Cases of HPV‐Positive Squamous Cell Carcinoma of the Tonsil?

et al. 2019

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“…In a review by Joseph AW et al, three models/mechanisms of pathogenesis were described. This included the theory of 'Field Cancerization' in which a persistent HPV infection may cause synchronous carcinomas at different anatomical sites, a second mechanism that multiple independent infections from several HPV types infect different areas of squamous epithelium resulting in carcinoma at different sites and a third postulated mechanism that primary HPV-induced tonsillar carcinoma subsequently generated a monoclonal second primary carcinoma in the contralateral tonsil by migration of HPV-infected cells [8,9].…”

Section: Discussionmentioning

confidence: 99%

“…NCCN guidelines provide no clear recommendation on the treatment of bilateral palatine tonsillar SCC. In a recent report by Christine M Kim et al they stressed that the contralateral tonsil should routinely be removed in the setting of a known unilateral HPV positive palatine tonsillar SCC since missing a occult contralateral malignancy has grave prognostic implications [9]. Rokkjaer et al concluded that bilateral tonsillectomy should be recommended in all patients with suspected or biopsy-proven palatine tonsillar SCC (unilateral or bilateral) and in those with carcinoma of unknown primary.…”

Section: Discussionmentioning

confidence: 99%

Synchronous HPV positive bilateral palatine tonsillar squamous cell carcinoma – Brief review of current literature on the role of magnetic resonance imaging

Arora¹,

Taheri²,

Joshi³

et al. 2021

J Clin Images Med Case Rep

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Synchronous bilateral palatine tonsillar Squamous Cell Carcinoma (SCC) is a rare presentation and less than 10 cases of Human Papillomavirus (HPV) mediated synchronous bilateral palatine tonsillar SCC has been reported. We report case of a patient who presents with a painless left sided neck swelling and was subsequently diagnosed by imaging and histopathology with bilateral Squamous Cell Carcinoma (SCC) of the palatine tonsil and cervical nodal metastasis. Due to its excellent soft tissue/tumor contrast resolution, Magnetic Resonance Imaging (MRI) is the preferred imaging modality for initial staging. Improved sensitivity for the detection of synchronous tumors can be achieved by Positron Emission Tomography (PET)/ Computed Tomography (CT) examination. Due to the rare nature of this pathology, no specific treatment guideline has been provided by National Comprehensive Cancer Network (NCCN). Treatment options available include bilateral Transoral Robotic Surgery (TORS) radical tonsillectomy combined with bilateral neck dissection with adjuvant radiotherapy or chemoradiotherapy and/or upfront concurrent chemoradiotherapy.

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Should the Contralateral Tonsil Be Removed in Cases of HPV‐Positive Squamous Cell Carcinoma of the Tonsil?

Cited by 9 publications

References 5 publications

Systematic Review of Second Primary Oropharyngeal Cancers in Patients With p16+ Oropharyngeal Cancer

Systematic Review of Second Primary Oropharyngeal Cancers in Patients With p16+ Oropharyngeal Cancer

In Reference to Should the Contralateral Tonsil Be Removed in Cases of HPV‐Positive Squamous Cell Carcinoma of the Tonsil?

Synchronous HPV positive bilateral palatine tonsillar squamous cell carcinoma – Brief review of current literature on the role of magnetic resonance imaging

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