Combined surgery and radiation improves survival of tonsil squamous cell cancers

Oncotarget. 2017 Aug 10;8(68):112442-112450. doi: 10.18632/oncotarget.20122. eCollection 2017 Dec 22.

Abstract

Objective: The study evaluated the addition of surgery (S) to radiation (RT) on survival of squamous cell carcinomas (SCC) of tonsillar-fossa (TF) in a modern cohort with similar epidemiology and treatment as current patients.

Study design: Retrospective analysis utilizing Surveillance, Epidemiology, and End Results (SEER) Program data.

Results: For all stages combined TF patients who received S+RT had superior OS (p < 0.01) and DSS (p < 0.01). For each stage OS and DSS was superior for S+RT (p < 0.05). In multivariate analysis, HRs for OS were statistically significantly higher for TF patients (stage 2, 3, and 4) receiving RT alone (p < 0.001).

Materials and methods: TF SCC patients treated with either S+RT or RT alone between 2004 and 2011 were examined (n = 6,476). Primary outcome measures included overall survival (OS) and disease specific survival (DSS). Cox proportional hazard ratios (HR) were estimated for patients treated with S+RT compared to RT alone.

Conclusions: OS and DSS were superior for all stages combined and for stages 2, 3, and 4 in TF patients who received S+RT compared to RT alone.

Keywords: HPV; IMRT; SCCHN; TORS; tonsillar fossa.