Role of surgery in limited (T1-2, N0-1) cancers of the oropharynx

• Published in: The Laryngoscope Vol. 118; no. 12; p. 2129
• Main Authors: Walvekar, Rohan R, Li, Ryan J, Gooding, William E, Gibson, Michael K, Heron, Dwight, Johnson, Jonas T, Ferris, Robert L
• Format: Journal Article
• Language: English
• Published: United States 01.12.2008
• Subjects: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell - drug therapy; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - radiotherapy; Carcinoma, Squamous Cell - surgery; Chemotherapy, Adjuvant; Cohort Studies; Combined Modality Therapy; Disease-Free Survival; Female; Humans; Kaplan-Meier Estimate; Lymphatic Metastasis - pathology; Male; Middle Aged; Neck Dissection; Neoplasm Staging; Oropharyngeal Neoplasms - drug therapy; Oropharyngeal Neoplasms - pathology; Oropharyngeal Neoplasms - radiotherapy; Oropharyngeal Neoplasms - surgery; Radiotherapy, Adjuvant
• ISSN: 1531-4995
• DOI: 10.1097/MLG.0b013e3181857950

To define the role of surgical staging in limited (T1-2, N0-1) oropharyngeal squamous cell cancers. Retrospective. Forty-nine limited oropharyngeal squamous cell cancers of the tonsil, tongue base, or posterior pharyngeal wall-treated surgically were identified. Thirty-five percent were cT1 and 65% were cT2 tumors although 58% were cN0 and 42% were cN1. Forty-six patients underwent neck dissections. Surgical staging altered T-stage in 26% (13/49), nodal status in 23% (11/46), and clinical staging in 40% (20/49) of patients. Among 35 disease-free patients, 28% (4/20) of stage I/II patients received postoperative radiation and chemotherapy was avoided in 80% (12/15) of stage III patients. T1 tumors seemed to have better outcomes (P = .06). The 3 year disease-free survival and 5 year overall survival was 85% and 83%, respectively. Surgical staging identifies patients in whom intensification of treatment with chemotherapy can be most appropriately applied, and enables de-intensification of therapy in pathology confirmed stage I/II disease.