title: Tonsillar squamous cell carcinoma: are we making a difference?
abstract: OBJECTIVE
  To analyze outcomes in patients with squamous cell carcinoma (SCCA) of the tonsil from the years 1998 to 2006. To assess factors that may affect disease-specific survival, such as patient characteristics and/or treatment modality.
  
  
  METHODS
  National Cancer Institute's Surveillance Epidemiology and End Results (SEER) program.
  
  
  METHODS
  The SEER database was used to perform a population-based cohort analysis for patients diagnosed with SCCA of the tonsil from 1998 to 2006. Disease-specific survival was correlated with sex, age, ethnicity, year of diagnosis, and treatment modality in a univariate Cox proportional hazards analysis and a multiple Cox-regression model with and without interaction effect.
  
  
  RESULTS
  Applied inclusion criteria resulted in 8378 patients. Of this patient cohort, 80% were male and 85% were white. The mean patient age at diagnosis was 58.1 years. On univariate and multivariate analyses, ethnicities other than white carried a significantly higher rate of disease-specific death (hazard ratio = 1.71, P < .001). Each additional year of age at the time of diagnosis carried approximately a 4% increase in likelihood of disease-specific death. With each passing year of time at diagnosis, patients carried a decreased risk of disease-specific death (P < .001); this value was significant in all 3 statistical models. Patients who underwent external-beam radiation had a higher likelihood of disease-specific survival with each passing year at time of diagnosis.
  
  
  CONCLUSIONS
  Population analysis based on the SEER database reveals increased disease-specific survival from tonsillar SCCA in more recent years. This may be because of earlier diagnosis, an increase in less aggressive subtypes of SCCA, and more effective treatment modalities.
authors.affiliation: UCLA Medical Center, Los Angeles, California, USA. miaedwards@mednet.ucla.edu
authors.forename: Mia E
authors.initials: ME
authors.lastname: Miller
authors.forename: David A
authors.initials: DA
authors.lastname: Elashoff
authors.forename: Elliot
authors.initials: E
authors.lastname: Abemayor
authors.forename: Maie
authors.initials: M
authors.lastname: St John
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D018426:SEER Program; D015996:Survival Rate; D014067:Tonsillar Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D014068:Tonsillectomy