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Minimal benefit of tonsillectomy in T1-T2 tonsillar squamous cell carcinoma treated with chemoradiotherapy.
- Source :
-
Journal of the Chinese Medical Association : JCMA [J Chin Med Assoc] 2016 Oct; Vol. 79 (10), pp. 570-6. Date of Electronic Publication: 2016 Jul 19. - Publication Year :
- 2016
-
Abstract
- Background: Chemoradiotherapy (CRT) has become the mainstay of treatment for tonsillar squamous cell carcinoma (SCC). Pre-CRT tonsillectomy is frequently performed, mostly for small primary tumors (T1-T2). However, the benefits of pre-CRT tonsillectomy remain unclear.<br />Methods: A retrospective review was performed in 66 patients with T1-T2 tonsillar SCCs treated by CRT from 1997 to 2009. The efficacy of pre-CRT tonsillectomy was analyzed with regard to oncological and functional outcomes.<br />Results: Thirty patients (45.5%) received tonsillectomy (pre-CRT tonsillectomy group), and 36 patients (54.5%) did not (CRT group). Except for a trend toward more T1 cases (33.3% vs. 13.9%, p = 0.061) and significantly less chemotherapy use (60% vs. 86.1%, p = 0.016) in the pre-CRT tonsillectomy group, there were no differences between the two groups in terms of age, gender, N classification (nodal status), overall stage, radiation dose, duration, or technique. In the pre-CRT tonsillectomy group, eight cases (26.7%) achieved an adequate operative margin judged by the surgeon, and only one (12.5%) had a negative pathological margin. In long-term follow-up, there were no statistically significant differences between the two groups regarding local (93.3% vs. 91.7%, p = 0.82) or regional control (93.3% vs. 94.4%, p = 0.84). The pre-CRT tonsillectomy group did not have a better 5-year disease-specific survival rate (83.3% vs. 94.4%, p = 0.177) or 5-year overall survival rate (70% vs. 94.4%, p = 0.017). There were no differences in complications or functional results (feeding tube and tracheostomy dependence), and quality of life demonstrated no significant difference.<br />Conclusion: Pre-CRT tonsillectomy contributes little to oncological and functional outcomes in patients with T1-T2 tonsillar SCC.<br /> (Copyright © 2016. Published by Elsevier Taiwan LLC.)
- Subjects :
- Carcinoma, Squamous Cell mortality
Carcinoma, Squamous Cell psychology
Female
Humans
Male
Middle Aged
Quality of Life
Retrospective Studies
Tonsillar Neoplasms mortality
Tonsillar Neoplasms psychology
Carcinoma, Squamous Cell therapy
Chemoradiotherapy
Tonsillar Neoplasms therapy
Tonsillectomy
Subjects
Details
- Language :
- English
- ISSN :
- 1728-7731
- Volume :
- 79
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Journal of the Chinese Medical Association : JCMA
- Publication Type :
- Academic Journal
- Accession number :
- 27449724
- Full Text :
- https://doi.org/10.1016/j.jcma.2016.06.001