External Radiotherapy in the Treatment of Tonsillar Carcinomas. Analysis of 183 Cases

Abstract

A retrospective analysis of 183 consecutive patients with tonsillar carcinoma obserevd from 1970 through 1984 and treated by external radiotherapy was carried out. The data were analyzed retrospectively to determine the factors affecting prognosis. Tumor size (T) and lymph node involvement (N) were found to be predominant prognostic factors. The difference in 5 year survival rate between T2 and T3 tumors was significant, and that between N1 and N3 was highly significant, whereas difference in survival could be found between N0 and N1 groups. The primary tumor was controlled by radiotherapy alone in 90% of cases of T1 lesions, 58% of T2, 37% of T3 and 11% of T4, and lymph node metastases was controlled in 70% of N1 cases, 0 of N2 and 15.5% of N3. Twenty-three patients underwent salvage surgery after radiotherapy had failed and the actuarial 5 year survival rate was 75% for stage I, 40% for stage II, 30% for stage III and 13% for stage IV.

Additional parameters to improve the prognostic value of the 8th edition of the UICC classification for human papillomavirus‐related oropharyngeal tumors

“…In the literature, the predictive value of the 7th edition of the TNM classification for oropharyngeal carcinomas, and for N classification in particular, has shifted over time as a consequence of the epidemic of HPV‐associated HNSCCs 13–34 . This shift prompted the publication of a new edition of the UICC staging system.…”

“…We found 10 studies published prior to 1990 all reporting N classification to be of prognostic importance (although only 2 studies provided results based on statistical analysis), while only 4 out of 12 studies published from 1990 onwards showed N classification to be of prognostic relevance (see Table 1). 13–34 In a previous study we tested the prognostic value of N classification in a group of 81 HPV‐positive and HPV‐negative TSCCs and found a decrease in prognostic value of N classification in the whole group 35 . N classification was of prognostic relevance only when tonsillar tumors were not HPV‐associated.…”

Head and Neck Cancer

“…Adequate radiotherapy achieves local control in approximately 60% to 80'% of T ? tumors and 40'K to 60% of T3 tumors (82,(90)(91)(92)(93)(94)(95). and surgery is reserved for recurrence.…”