Ebisumoto Koji, Okami Kenji, Maki Daisuke, Saito Kosuke, Shimizu Fukuko, Teramura Takanobu, Kaneda Shoji, Iida Masahiro
Department of Otolaryngology-Head and Neck Surgery Tokai University Kanagawa Japan.
Laryngoscope Investig Otolaryngol. 2017 Mar 10;2(2):63-68. doi: 10.1002/lio2.70. eCollection 2017 Apr.
everal 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.
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.
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).
Postoperative irradiation for cervical lymph node metastases might be avoidable in selected patients with human papillomavirus-related tonsillar cancer.
