Relapse patterns after transoral laser microsurgery and postoperative irradiation for squamous cell carcinomas of the tonsil and tongue base

Samir H. Patel, Nathan D. Munson, David G. Grant, Steven J. Buskirk, Michael L. Hinni, William C. Perry, Robert L. Foote, Rebecca B. McNeil, Michele Y. Halyard

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Objectives: We evaluated relapse patterns after transoral laser microsurgery (TLM) in squamous cell carcinoma (SCC) of the tonsil and tongue base and evaluated the indications for adjuvant irradiation. Methods: Between December 1, 1996, and December 31, 2005, 79 patients with previously untreated SCC of the tonsil or tongue base underwent TLM with or without neck dissection. Thirty-eight patients (48%) underwent postoperative irradiation (median, 62 Gy) to the primary site and the neck. Analysis of relapse patterns was performed on the basis of adverse risk factors and the presence or absence of adjuvant irradiation. Results: The median follow-up for living patients was 47 months (range, 10 to 107 months), and patients were monitored for at least 2 years or until recurrence or death. Local, regional, and distant treatment failures numbered 4, 6, and 4 for surgery alone (n = 41) and 0, 2, and 6 for adjuvant irradiation (n = 38), respectively. Patients with high-risk features (extracapsular extension or at least 2 adverse factors) had locoregional control rates at 2 or more years of 66% and 94% for TLM alone and TLM plus adjuvant irradiation, respectively. Conclusions: Adjuvant irradiation after TLM resection of oropharyngeal SCC with intermediate- or high-risk features improves locoregional control compared with TLM alone.

Original languageEnglish (US)
Pages (from-to)32-39
Number of pages8
JournalAnnals of Otology, Rhinology and Laryngology
Volume123
Issue number1
DOIs
StatePublished - Jan 2014

Keywords

  • Oropharyngeal cancer
  • Radiation
  • Radiation therapy
  • Transoral laser microsurgery

ASJC Scopus subject areas

  • Otorhinolaryngology

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    Patel, S. H., Munson, N. D., Grant, D. G., Buskirk, S. J., Hinni, M. L., Perry, W. C., Foote, R. L., McNeil, R. B., & Halyard, M. Y. (2014). Relapse patterns after transoral laser microsurgery and postoperative irradiation for squamous cell carcinomas of the tonsil and tongue base. Annals of Otology, Rhinology and Laryngology, 123(1), 32-39. https://doi.org/10.1177/0003489414521383