Therapeutic options in patients with early T stage and advanced N stage of tonsillar squamous cell carcinomas.
OBJECTIVE
To compare the therapeutic role of surgery followed by radiotherapy (OPRT) and concurrent chemoradiotherapy (CCRT) in patients with early T (T1/T2) and advanced N (N2/N3) stage tonsillar squamous cell carcinoma.


METHODS
Historical cohort study.


METHODS
A tertiary hospital.


METHODS
The medical records of 42 patients who met the eligible criteria (24 patients were treated by OPRT, 18 patients by CCRT) were reviewed.


RESULTS
Mean overall survival (OS) and disease-free survival (DFS) were 49.0 months and 43.0 months in OPRT group, respectively, and 39.6 months and 35.0 months in CCRT group, respectively (P = 0.18 for OS, P = 0.29 for DFS between the two groups). There was also no significant difference in survival estimates between OPRT and CCRT group in terms of two-year OS (P = 0.18) and two-year DFS (P = 0.45). In the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, the scores for global health status and symptom scales did not differ between the two groups. However, the OPRT group reported better functional scales and significantly higher scores for cognitive (P = 0.008) and social function (P = 0.03). Among single items, a significantly lower score for insomnia (P = 0.007) was noted in the OPRT group. In EORTC QLQ-H&N35 modules, there were no significantly different scales between the two groups except scores for nutritional supplements, in which the OPRT group presented lower symptom scores (P = 0.02).


CONCLUSIONS
OPRT could be still a viable option for managing selected cases of advanced oropharyngeal cancer because one can expect comparable therapeutic outcome as well as quality of life.
Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
Man Ki
MK
Chung
Young-Ik
YI
Son
Jae Keun
JK
Cho
Yoon Kyoung
YK
So
Seung Hoon
SH
Woo
Han-Sin
HS
Jeong
Chung-Hwan
CH
Baek
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D003131:Combined Modality Therapy; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016019:Survival Analysis; D014067:Tonsillar Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome