Supported by The Stout Family Fund for Head Neck Cancer Research.
Role of Surgery in Limited (T1-2, N0-1) Cancers of the Oropharynx†
Version of Record online: 2 JAN 2009
Copyright © 2008 The Triological Society
Volume 118, Issue 12, pages 2129–2134, December 2008
How to Cite
Walvekar, R. R., Li, R. J., Gooding, W. E., Gibson, M. K., Heron, D., Johnson, J. T. and Ferris, R. L. (2008), Role of Surgery in Limited (T1-2, N0-1) Cancers of the Oropharynx. The Laryngoscope, 118: 2129–2134. doi: 10.1097/MLG.0b013e3181857950
- Issue online: 2 JAN 2009
- Version of Record online: 2 JAN 2009
- Manuscript Accepted: 2 JUL 2008
- Oropharyngeal cancer;
- squamous cell carcinoma;
- surgical therapy
Hypothesis: To define the role of surgical staging in limited (T1-2, N0-1) oropharyngeal squamous cell cancers.
Study Design: Retrospective.
Methods: Forty-nine limited oropharyngeal squamous cell cancers of the tonsil, tongue base, or posterior pharyngeal wall-treated surgically were identified.
Results: 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.
Conclusions: 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.