Different prognostic indices in 310 patients with tonsillar carcinomas.
BACKGROUND
Several modifications of the TNM system have been reported as better prognostic tools than the original classification in head and neck cancer, but none of these modifications has been tested in a large series of tonsillar carcinomas. These studies did not examine host and treatment factors as predictors in addition to TNM.


METHODS
Three hundred and ten consecutively untreated patients with squamous cell carcinoma of the tonsillar region admitted to the Norwegian Radium Hospital and/or the National Hospital between 1960 and 1996 were included.


RESULTS
The five reported TN-based stage modifications were all highly significant predictors of survival. Four clinical variables indicating shorter disease-specific survival were identified: age > 60, male gender, total radiation dose < 70 Gy, and duration of radiotherapy > 50 days.


CONCLUSIONS
Earlier reported TNM-based stage modifications are all very useful predictors of survival in tonsillar carcinomas. In addition, age, gender, total radiation dose, and duration of radiotherapy were important prognostic factors. We propose that both host and treatment factors should be tested carefully when building new prognostic indices in tonsillar carcinomas.
Hannisdal
Kirsten
K
Department of Oto-rhino-laryngology, Rikshospitalet, University of Oslo, N-0027 Oslo, Norway. kirsten.hannisdal@rikshospitalet.no
Boysen
Morten
M
Evensen
Jan F
JF
D000367:Age Factors; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D011879:Radiotherapy Dosage; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012737:Sex Factors; D013223:Statistics as Topic / Q000379:methods; D016019:Survival Analysis; D013997:Time Factors; D014067:Tonsillar Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy