title: Disease-specific survival and locoregional control in tonsillar carcinoma.
abstract: In a nationwide survey on oropharyngeal carcinoma in the Netherlands (1986-1990), 380 patients with a tonsillar carcinoma were retrospectively studied. The records of 268 (71%) men and 112 (29%) women with a median age of 59 yr (range 31-91), who had squamous cell carcinoma (272 patients, 98%) or undifferentiated carcinoma (8 patients, 2%) were reviewed with respect to treatment, disease-specific survival and locoregional control. Distribution by stage according to the UICC'92 system was: 27 patients (7%) stage I, 59 (15%) stage II, 99 (26%) stage III, 182 (48%) stage IV and 13 patients (3%) unknown stage. Using a previously reported revised staging system the following distribution was obtained: 118 patients (31%) stage I, 120 (31%) stage II, 67 (18%) stage III, 54 (14%) stage IV and 21 patients (6%) with an unknown stage. Treatment consisted of radiotherapy alone in 231 patients (61%), surgery and radiotherapy in 101 (27%), surgery alone in 30 (8%), chemotherapy in 5 (2%) and 13 patients (3%) did not receive any treatment. At 5-yr the overall survival was 32%, the disease-specific survival 42% and the locoregional control 61%. In patients treated with radiotherapy alone the disease-specific survival was 39%, for surgery and radiotherapy 53% and for surgery alone 83%. The disease-specific survival according to UICC'92 stage was 71% in stage I, 59% in II, 50% in III and 32% in stage IV (P < 0.0001). In the revised staging the survival figures were 63% in stage I, 43% in II, 31% in III and 9% in IV (P < 0.0001). The two staging systems appeared to be comparable in prognostic discrimination; the clinical relevance of the revised stage might, however, be slightly superior to the UICC'92 version. The difference in results after radiotherapy alone and surgery + radiotherapy remained significant, also after adjusting for stage (P < 0.0001).
authors.affiliation: Comprehensive Cancer Centre, Amsterdam, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Mak-Kregar
authors.forename: F J
authors.initials: FJ
authors.lastname: Hilgers
authors.forename: P C
authors.initials: PC
authors.lastname: Levendag
authors.forename: J J
authors.initials: JJ
authors.lastname: Manni
authors.forename: A A
authors.initials: AA
authors.lastname: Hart
authors.forename: O
authors.initials: O
authors.lastname: Visser
authors.forename: P P
authors.initials: PP
authors.lastname: Knegt
authors.forename: H A
authors.initials: HA
authors.lastname: Marres
authors.forename: F W
authors.initials: FW
authors.lastname: Ten Broek
authors.forename: F R
authors.initials: FR
authors.lastname: Burlage
authors.forename: J M
authors.initials: JM
authors.lastname: Van der Beek
authors.forename: R J
authors.initials: RJ
authors.lastname: Baatenburg de Jong
mesh_terms: D002277:Carcinoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009426:Netherlands / Q000453:epidemiology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D014067:Tonsillar Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy