Role of Tonsillectomy in the Management of Carcinomas of Unknown Primary of the Head and Neck: A Retrospective Study Based on p16 Analysis

Frontiers in Oncology
Pauline PodeurNicolas Fakhry

Abstract

To evaluate the impact of tonsillectomy on the detection of the primary tumor, based on p16 immunohistochemistry analysis, in patients with cervical unknown primary of squamous cell carcinoma (SCC-CUP). This was a retrospective study of 63 patients, included from January 2008 to December 2017 in a single institution. All patients had an initial assessment with physical examination, CT scan of the neck and chest, whole body FDG-PET CT, and endoscopy under general anesthesia, which failed to determine the primary tumor. Forty-seven out of the 63 patients had an ipsi- or bilateral tonsillectomy which revealed 12 tonsil cancers (26%). The tonsil primary was ipsilateral to positive nodes in 10 cases, contralateral in 1 case and, in 1 case, the patient had bilateral neck involvement. The analysis of the p16 status was carried out in 41/63 patients (65%). Among the 32 patients who had a p16 analysis and tonsillectomy, the rate of primary detection was 59% (10/17) for p16-postives and 0% (0/15) for p16-negatives (p < 0.001). These results suggest that an extended work-up should be systematically proposed including bilateral tonsillectomy (+/- mucosectomy of the base of tongue) in SCC-CUP p16-positive patients but not in p16-negatives.

References

Mar 10, 2001·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·W M KochD W Eisele
Jan 2, 2009·The Laryngoscope·Joshua D WaltonenAmit Agrawal
May 17, 2015·Surgical Oncology Clinics of North America·Jeffrey M Martin, Thomas J Galloway
Jun 17, 2016·Acta Oto-laryngologica·Lovisa FarneboAntti Mäkitie
Dec 28, 2016·Cancer Treatment Reviews·Alberto Daniele ArosioWerner Garavello
Mar 21, 2017·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Basel Al KadahMarcus Niewald
Nov 22, 2017·Head & Neck·Antoine EskanderUNKNOWN Education Committee of American Head and Neck Society (AHNS)
Sep 7, 2018·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Carole FakhryBayardo Perez-Ordonez
Apr 24, 2020·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Ellie MaghamiJames Caudell

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Methods Mentioned

BETA
biopsy
biopsies
dissection
by

Software Mentioned

SPSS Statistics
TORS

Related Concepts

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Carcinoma, Squamous Cell

Basal cell carcinoma is a form of malignant skin cancer found on the head and neck regions and has low rates of metastasis. Discover the latest research on basal cell carcinoma here.

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