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- Title
Avoidance of postoperative irradiation for cervical lymph node metastases of human papillomavirus-related tonsillar cancer.
- Authors
Ebisumoto, Koji; Okami, Kenji; Maki, Daisuke; Saito, Kosuke; Shimizu, Fukuko; Teramura, Takanobu; Kaneda, Shoji; Iida, Masahiro
- Abstract
Background Several reports have suggested that selected patients with human papillomavirus-related oropharyngeal cancer can be managed with surgery alone. We retrospectively reviewed tonsillar cancer cases to analyze treatment de-intensification after transoral resection. Methods Eighteen patients with tonsillar cancer who had undergone transoral resection were included. The patients' characteristics, p16 status, adverse features, clinical course, overall survival, and relapse-free survival according to p16 status were retrospectively examined. Results Four lesions showed positive surgical margins and one lesion showed close surgical margin; these patients were treated with postoperative irradiation. Seven p16-positive patients had multiple node metastases and two had extracapsular spread. No p16-positive patients agreed to postoperative irradiation, and recurrence within the surgical field was not observed. The five-year overall and relapse-free survival rates were 89% and 74%, respectively. The five-year relapse-free survival rates of p16-positive and p16-negative patients were 81% and 50%, respectively (p = .075). Conclusions Postoperative irradiation for cervical lymph node metastases might be avoidable in selected patients with human papillomavirus-related tonsillar cancer. Level of Evidence 4.
- Subjects
CANCER; LYMPH nodes; PAPILLOMAVIRUSES; IRRADIATION; RADIATION
- Publication
Laryngoscope Investigative Otolaryngology, 2017, Vol 2, Issue 2, p63
- ISSN
2378-8038
- Publication type
Article
- DOI
10.1002/lio2.70