Tonsil cancer: Patterns of failure after surgery alone and surgery combined with postoperative radiation therapy

R. L. Foote, S. E. Schild, W. M. Thompson, S. J. Buskirk, K. D. Olsen, R. J. Stanley, S. J. Kunselman, Daniel J Schaid, J. P. Grill

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Background. The authors determined the patterns of treatment failure in patients treated with surgery alone or surgery combined with postoperative radiation therapy for squamous cell carcinoma of the tonsil. Methods. Seventy-two patients underwent surgery alone (56) or surgery and postoperative adjuvant radiation therapy (16). All patients were followed up until death (40 patients) or for a minimum of 3.5 years. For patients treated with surgery alone, clinic notes, operative notes, and pathology reports and slides were reviewed to identify clinical or pathologic predictors of recurrence above the clavicles, cause-specific survival, and overall survival. For patients undergoing postoperative adjuvant radiation therapy, demographic, treatment, and pathologic variables were analyzed to identify factors associated with control of disease above the clavicles, disease-free survival, and overall survival. Results. The main pattern of treatment failure was above the clavicles. It occurred in 39% of patients treated with surgery alone and was significantly related (P = 0.002) to the overall clinical TNM stage. Disease recurrence above the clavicles occurred in 31% of patients undergoing surgery and postoperative adjuvant radiation therapy, despite their more advanced neck disease. Five-year overall survival for patients with clinical Stage III and IV disease who were treated with surgery and post-operative adjuvant radiation therapy was 100% and 78%, respectively. Five-year overall survival for patients treated with surgery alone who had clinical Stage III, IVA, or IVB disease was 56%, 43%, and 50%, respectively. Conclusion. We recommend postoperative adjuvant radiation therapy for patients with clinical Stage III or IV squamous cell carcinoma of the tonsil who have undergone complete surgical resection because this appears to improve control of disease above the clavicles and overall survival.

Original languageEnglish (US)
Pages (from-to)2638-2647
Number of pages10
JournalCancer
Volume73
Issue number10
DOIs
StatePublished - 1994

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Tonsillar Neoplasms
Radiotherapy
Clavicle
Survival
Palatine Tonsil
Treatment Failure
Squamous Cell Carcinoma
Recurrence
Disease-Free Survival

Keywords

  • radiation therapy
  • squamous cell carcinoma surgery
  • tonsil

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Foote, R. L., Schild, S. E., Thompson, W. M., Buskirk, S. J., Olsen, K. D., Stanley, R. J., ... Grill, J. P. (1994). Tonsil cancer: Patterns of failure after surgery alone and surgery combined with postoperative radiation therapy. Cancer, 73(10), 2638-2647. https://doi.org/10.1002/1097-0142(19940515)73:10<2638::AID-CNCR2820731028>3.0.CO;2-H

Tonsil cancer : Patterns of failure after surgery alone and surgery combined with postoperative radiation therapy. / Foote, R. L.; Schild, S. E.; Thompson, W. M.; Buskirk, S. J.; Olsen, K. D.; Stanley, R. J.; Kunselman, S. J.; Schaid, Daniel J; Grill, J. P.

In: Cancer, Vol. 73, No. 10, 1994, p. 2638-2647.

Research output: Contribution to journalArticle

Foote, RL, Schild, SE, Thompson, WM, Buskirk, SJ, Olsen, KD, Stanley, RJ, Kunselman, SJ, Schaid, DJ & Grill, JP 1994, 'Tonsil cancer: Patterns of failure after surgery alone and surgery combined with postoperative radiation therapy', Cancer, vol. 73, no. 10, pp. 2638-2647. https://doi.org/10.1002/1097-0142(19940515)73:10<2638::AID-CNCR2820731028>3.0.CO;2-H
Foote, R. L. ; Schild, S. E. ; Thompson, W. M. ; Buskirk, S. J. ; Olsen, K. D. ; Stanley, R. J. ; Kunselman, S. J. ; Schaid, Daniel J ; Grill, J. P. / Tonsil cancer : Patterns of failure after surgery alone and surgery combined with postoperative radiation therapy. In: Cancer. 1994 ; Vol. 73, No. 10. pp. 2638-2647.
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abstract = "Background. The authors determined the patterns of treatment failure in patients treated with surgery alone or surgery combined with postoperative radiation therapy for squamous cell carcinoma of the tonsil. Methods. Seventy-two patients underwent surgery alone (56) or surgery and postoperative adjuvant radiation therapy (16). All patients were followed up until death (40 patients) or for a minimum of 3.5 years. For patients treated with surgery alone, clinic notes, operative notes, and pathology reports and slides were reviewed to identify clinical or pathologic predictors of recurrence above the clavicles, cause-specific survival, and overall survival. For patients undergoing postoperative adjuvant radiation therapy, demographic, treatment, and pathologic variables were analyzed to identify factors associated with control of disease above the clavicles, disease-free survival, and overall survival. Results. The main pattern of treatment failure was above the clavicles. It occurred in 39{\%} of patients treated with surgery alone and was significantly related (P = 0.002) to the overall clinical TNM stage. Disease recurrence above the clavicles occurred in 31{\%} of patients undergoing surgery and postoperative adjuvant radiation therapy, despite their more advanced neck disease. Five-year overall survival for patients with clinical Stage III and IV disease who were treated with surgery and post-operative adjuvant radiation therapy was 100{\%} and 78{\%}, respectively. Five-year overall survival for patients treated with surgery alone who had clinical Stage III, IVA, or IVB disease was 56{\%}, 43{\%}, and 50{\%}, respectively. Conclusion. We recommend postoperative adjuvant radiation therapy for patients with clinical Stage III or IV squamous cell carcinoma of the tonsil who have undergone complete surgical resection because this appears to improve control of disease above the clavicles and overall survival.",
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T1 - Tonsil cancer

T2 - Patterns of failure after surgery alone and surgery combined with postoperative radiation therapy

AU - Foote, R. L.

AU - Schild, S. E.

AU - Thompson, W. M.

AU - Buskirk, S. J.

AU - Olsen, K. D.

AU - Stanley, R. J.

AU - Kunselman, S. J.

AU - Schaid, Daniel J

AU - Grill, J. P.

PY - 1994

Y1 - 1994

N2 - Background. The authors determined the patterns of treatment failure in patients treated with surgery alone or surgery combined with postoperative radiation therapy for squamous cell carcinoma of the tonsil. Methods. Seventy-two patients underwent surgery alone (56) or surgery and postoperative adjuvant radiation therapy (16). All patients were followed up until death (40 patients) or for a minimum of 3.5 years. For patients treated with surgery alone, clinic notes, operative notes, and pathology reports and slides were reviewed to identify clinical or pathologic predictors of recurrence above the clavicles, cause-specific survival, and overall survival. For patients undergoing postoperative adjuvant radiation therapy, demographic, treatment, and pathologic variables were analyzed to identify factors associated with control of disease above the clavicles, disease-free survival, and overall survival. Results. The main pattern of treatment failure was above the clavicles. It occurred in 39% of patients treated with surgery alone and was significantly related (P = 0.002) to the overall clinical TNM stage. Disease recurrence above the clavicles occurred in 31% of patients undergoing surgery and postoperative adjuvant radiation therapy, despite their more advanced neck disease. Five-year overall survival for patients with clinical Stage III and IV disease who were treated with surgery and post-operative adjuvant radiation therapy was 100% and 78%, respectively. Five-year overall survival for patients treated with surgery alone who had clinical Stage III, IVA, or IVB disease was 56%, 43%, and 50%, respectively. Conclusion. We recommend postoperative adjuvant radiation therapy for patients with clinical Stage III or IV squamous cell carcinoma of the tonsil who have undergone complete surgical resection because this appears to improve control of disease above the clavicles and overall survival.

AB - Background. The authors determined the patterns of treatment failure in patients treated with surgery alone or surgery combined with postoperative radiation therapy for squamous cell carcinoma of the tonsil. Methods. Seventy-two patients underwent surgery alone (56) or surgery and postoperative adjuvant radiation therapy (16). All patients were followed up until death (40 patients) or for a minimum of 3.5 years. For patients treated with surgery alone, clinic notes, operative notes, and pathology reports and slides were reviewed to identify clinical or pathologic predictors of recurrence above the clavicles, cause-specific survival, and overall survival. For patients undergoing postoperative adjuvant radiation therapy, demographic, treatment, and pathologic variables were analyzed to identify factors associated with control of disease above the clavicles, disease-free survival, and overall survival. Results. The main pattern of treatment failure was above the clavicles. It occurred in 39% of patients treated with surgery alone and was significantly related (P = 0.002) to the overall clinical TNM stage. Disease recurrence above the clavicles occurred in 31% of patients undergoing surgery and postoperative adjuvant radiation therapy, despite their more advanced neck disease. Five-year overall survival for patients with clinical Stage III and IV disease who were treated with surgery and post-operative adjuvant radiation therapy was 100% and 78%, respectively. Five-year overall survival for patients treated with surgery alone who had clinical Stage III, IVA, or IVB disease was 56%, 43%, and 50%, respectively. Conclusion. We recommend postoperative adjuvant radiation therapy for patients with clinical Stage III or IV squamous cell carcinoma of the tonsil who have undergone complete surgical resection because this appears to improve control of disease above the clavicles and overall survival.

KW - radiation therapy

KW - squamous cell carcinoma surgery

KW - tonsil

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