Abstract
Objective: Analyze our experience in the management of tonsil SCC managed exclusively by surgical resection followed by postoperative radiotherapy (PORT) and to identify factors predictive of outcome.
Method: A retrospective chart review was conducted on 88 patients with tonsil SCC treated with surgery at Memorial Sloan-Kettering Cancer Center between 1985 and 2005. Overall survival (OS), disease-specific survival (DSS), recurrence-free survival (RFS) at 5 years, and predictors of survival were determined.
Results: Forty-eight percent had advanced T3/T4 stage and 75% had an N positive neck. With a median follow-up of 74 months, OS, DSS, and RFS at 5 years were 66%, 82%, and 80%, respectively. Age >60 years female gender, advanced T stage, positive margins, and lymphovascular invasion (LVI) were predictive of OS. Only positive margins and LVI predicted DSS while clinical T stage and LVI predicted RFS. The status of the neck was not predictive of outcome (DSS 80% for N0 patients vs 82% for N+, P = .97).
Conclusion: Advanced stage tonsil SCC patients managed with surgery and PORT had an excellent prognosis with outcome results comparable with those from concurrent chemoradiation. In contrast to advanced stage head and neck SCC at other sites, the pathological stage of the neck does not impact on outcome.
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