title: Management of the neck in node-positive tonsillar cancer.
abstract: CONCLUSIONS
  Neck dissection (ND) may not be warranted for those patients with complete response in the neck. Human papillomavirus (HPV)-positive or -negative tumour does not affect this recommendation.
  
  
  OBJECTIVE
  Treatment of tonsillar cancer varies considerably worldwide, although non-surgical treatment, e.g. radiotherapy (RT), possibly combined with chemotherapy (CRT), is gradually coming to be regarded as the first line of therapy. However, the optimal treatment of nodal disease remains controversial, and the fundamental question is if and when to perform ND.
  
  
  METHODS
  We performed a retrospective analysis of all patients with tonsillar cancer treated in the Stockholm area between 2000 and 2006. An analysis of node-positive tumours was done and the neck specimen was investigated for the presence of viable tumour cells after RT. A sub-analysis of HPV status was also carried out.
  
  
  RESULTS
  Following complete response after RT, 2% of patients showed viable cells in the neck specimen, compared with 60% in patients who did not show complete response. HPV-positive tumours had the same proportion of viable tumour cells in the neck specimen as HPV-negative tumours.
authors.affiliation: Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Karolinska Institutet, Karolinska University Hospital , Stockholm , Sweden.
authors.forename: Linda
authors.initials: L
authors.lastname: Marklund
authors.forename: Bertil
authors.initials: B
authors.lastname: Lundberg
authors.forename: Lalle
authors.initials: L
authors.lastname: Hammarstedt-Nordenvall
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods*; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D030361:Papillomavirus Infections / Q000473:pathology / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D013548:Sweden; D014067:Tonsillar Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy* / Q000821:virology; D016896:Treatment Outcome
keywords: HPV; Neck dissection; radiotherapy