1. History of tonsillectomy and risk of oropharyngeal cancer
- Author
-
Sophie Périé, Christian Righini, Sébastien Vergez, Nicolas Fakhry, Justine Lerat, Pierre Philouze, Nicolas Saroul, Jean-Damien Combes, Haitham Mirghani, Philippe Ceruse, Olivier Malard, Guillaume Buiret, Nicolas Voisin, Jean Lacau St Guily, Ritoungarte Nadjingar, Franck Jegoux, Emmanuel Bartaire, Gary M. Clifford, Renaud Garrel, Benjamin Verillaud, Silvia Franceschi, Centre International de Recherche contre le Cancer - International Agency for Research on Cancer (CIRC - IARC), Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Hospices Civils de Lyon (HCL), Clinique Hartmann [Neuilly-sur-Seine], Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Pontchaillou [Rennes], Chemistry, Oncogenesis, Stress and Signaling (COSS), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire [Grenoble] (CHU), Institut Gustave Roussy (IGR), Département de cancérologie cervico-faciale [Gustave Roussy] (CCF), CHU Lille, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Hôpital Rothschild [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Ligue nationale contre le cancerLigue nationale contre le cancer [LNCC CD69 2014], Institut National Du Cancer (INCa) Institut National du Cancer (INCA) France [2014/122], Italian Ministry of Health (Ricerca Corrente) Ministry of Health, Italy, Association pour la Recherche sur le Cancer (ARC)Fondation ARC pour la Recherche sur le Cancer [20111204169], Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier de Valence, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance Publique - Hôpitaux de Marseille (APHM), CHU Limoges, CHU Clermont-Ferrand, Hôpital Lariboisière-Fernand-Widal [APHP], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Rothschild [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
- Subjects
Cancer Research ,medicine.medical_specialty ,Tonsillar cancer ,Adolescent ,medicine.medical_treatment ,Palatine Tonsil ,Oropharyngeal Tumor ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,03 medical and health sciences ,0302 clinical medicine ,Tongue ,Internal medicine ,Base of the tongue cancer ,medicine ,Humans ,030223 otorhinolaryngology ,Head and neck cancer ,Tonsillectomy ,Oropharyngeal cancer ,business.industry ,Cancer ,Odds ratio ,medicine.disease ,3. Good health ,Oropharyngeal Neoplasms ,medicine.anatomical_structure ,Tonsil ,Oncology ,030220 oncology & carcinogenesis ,Oral Surgery ,business - Abstract
International audience; Objective: To investigate whether palatine tonsillectomy in youth influences the risk of oropharyngeal cancers (OPC) by assessing the association between history of tonsillectomy and risk of tonsillar, base of tongue (BOT) cancer, and other head and neck cancers (HNC). Materials and Methods: RACKAM was a case-case study comparing frequency of tonsillectomy history in individuals diagnosed with HNC from 2013 to 2018 in 15 centers across France. History of tonsillectomy was defined using combined assessment of patients and rsquo; recollections and surgeons and rsquo; visualizations of tonsil area. OPC subsite-specific odds ratios (OR) of tonsillectomy were calculated using multinomial logistic regression with nonoropharyngeal HNC as reference. Results: 1045 patients were included in the study. Frequency of tonsillectomy was 19.5% in patients with tonsillar cancer (N = 85), 49.3% in BOT (N = 76), 33.8% in other oropharyngeal cancers (N = 202) and 38.0% in non-oropharyngeal HNC (N = 682). History of tonsillectomy was inversely associated with tonsillar cancer (adjusted OR 0.4; 95% CI 0.2 and ndash;0.8), and positively associated with BOT cancer (adjusted OR 1.8; 95% CI 1.1 and ndash;3.1), but was not associated with all OPC combined (adjusted OR 1.1; 95% CI 0.8 and ndash;1.4). Sensitivity analyses considering only patients and rsquo; or surgeons and rsquo; assessments of tonsillectomy provided comparable results. Conclusion: We confirm the long-term protective effect of tonsillectomy performed in youth on future risk of tonsillar cancer, and our study is the second to report a concurrent increased risk of BOT cancer. Our data suggest that tonsillectomy in youth shifts the site of the first diagnosed oropharyngeal tumor and has a limited impact on overall risk of OPC.
- Published
- 2021