Department of Medicine and Surgery, University of Parma, Parma, Italy;
Department of General Surgery, Vaio Hospital, Fidenza, Italy.
Anticancer Res. 2023 Sep;43(9):3881-3889. doi: 10.21873/anticanres.16575.
Otorhinolaryngology tradition is that tonsillectomy (TE) is conducted among children and adolescents for obstructive sleep apnea secondary to adenotonsillar hypertrophy and in adults for chronic disease of the tonsils and adenoids (recurrent tonsillitis). Nevertheless, over the last 50 years, we have observed a decline in TE worldwide. As a result, there is an emerging concern of a correlated possible increased risk of tonsil cancer (TC) and other subtypes of oropharyngeal squamous cell carcinoma. Since the available data on such topics are limited and controversial, our aim was to elucidate the impact of TE on the incidence mainly of TC through a systematic review of the literature and a meta-analysis of the studies. After a thorough search, 7 retrospective studies were considered eligible for review and meta-analysis (MA). At MA, patients with a history of TE seem to show a reduced risk of TC but a higher predisposition for base of tongue (BOT) cancer (p<0.001): however, the elevated heterogeneity of the studies hampers drawing firm and convincing conclusions (statistical inconsistency >95%). In future, randomized control trials will be welcome to elucidate the prophylactic role of TE against TC and its real impact on BOT cancer.
耳鼻喉科的传统观点认为，腺样体扁桃体切除术（tonsillectomy，TE）适用于儿童和青少年因腺样体扁桃体肥大导致的阻塞性睡眠呼吸暂停，以及成年人因慢性扁桃体和腺样体疾病（复发性扁桃体炎）。然而，在过去的 50 年中，我们观察到全球 TE 的数量有所下降。因此，人们越来越担心这可能与扁桃体癌（tonsil cancer，TC）和其他口咽鳞状细胞癌亚型的风险增加有关。由于此类主题的可用数据有限且存在争议，我们的目的是通过系统回顾文献和对研究进行荟萃分析，阐明 TE 对 TC 发病率的影响。经过彻底搜索，有 7 项回顾性研究被认为符合纳入标准并可进行荟萃分析（meta-analysis，MA）。MA 结果显示，有 TE 病史的患者 TC 发病风险似乎降低，但舌根癌（base of tongue cancer，BOT）发病风险较高（p<0.001）：然而，研究的异质性较高，使得难以得出明确和有说服力的结论（统计学不一致性>95%）。未来，将欢迎开展随机对照试验来阐明 TE 预防 TC 的作用及其对 BOT 癌的实际影响。
