title: Squamous cell carcinoma of the tonsil managed by conventional surgery and postoperative radiation.
abstract: BACKGROUND
  The purpose of this study was to report the long-term outcome of patients with squamous cell cancer (SCC) of the tonsil managed by surgery followed by postoperative radiotherapy (PORT).
  
  
  METHODS
  Eighty-eight patients treated between 1985 and 2005 were analyzed. Overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) were determined by the Kaplan-Meier method. Factors predictive of outcome were determined by univariate and multivariate analysis.
  
  
  RESULTS
  Forty-eight percent of patients had T3 to T4 disease and 75% had a positive neck. Five-year OS, DSS, and RFS were 66%, 82%, and 80%, respectively. The status of the neck was not predictive of outcome (DSS 80% for N0 vs 82% for N+; p = .97). Lymphovascular invasion was an independent predictor of OS, DSS, and RFS on multivariate analysis.
  
  
  CONCLUSIONS
  Lymphovascular invasion but not pathological stage of the neck is an independent predictor of outcome in patients with tonsillar SCC.
authors.affiliation: Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.|Department of Otolaryngology-Head and Neck Surgery, Columbia University Medical Center, New York, New York.
authors.forename: Rahmatullah
authors.initials: R
authors.lastname: Rahmati
authors.affiliation: Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Snjezana
authors.initials: S
authors.lastname: Dogan
authors.affiliation: Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.|State University of New York - Stony Brook, School of Medicine, Stony Brook, New York.
authors.forename: Owen
authors.initials: O
authors.lastname: Pyke
authors.affiliation: Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Frank
authors.initials: F
authors.lastname: Palmer
authors.affiliation: Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Awad
authors.affiliation: Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Nancy
authors.initials: N
authors.lastname: Lee
authors.affiliation: Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.|Head and Neck Institute, North Shore Health System, Great Neck, New York.
authors.forename: Dennis H
authors.initials: DH
authors.lastname: Kraus
authors.affiliation: Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Jatin P
authors.initials: JP
authors.lastname: Shah
authors.affiliation: Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Snehal G
authors.initials: SG
authors.lastname: Patel
authors.affiliation: Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Ian
authors.initials: I
authors.lastname: Ganly
mesh_terms: D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D015331:Cohort Studies; D016001:Confidence Intervals; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008297:Male; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D014067:Tonsillar Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D014068:Tonsillectomy / Q000379:methods*; D016896:Treatment Outcome
keywords: human papillomavirus (HPV); oropharynx; prognostic factors; squamous cell carcinoma (SCC); surgery; tonsil