Surgical treatment of locally limited tonsillar cancer

BackgroundThis study aimed to assess the efficacy of primary surgical treatment in the management of locally limited tonsillar carcinoma and the incidence of occult cervical metastasis.MethodsWe conducted a retrospective evaluation of the records of all patients treated with primary surgery for pT1 and pT2 tonsillar carcinomas at a tertiary referral center between 1977 and 2005. All cases were assessed for disease-specific survival as well as local control rates, with respect to T and N classification, status of surgical margins, decision on neck management, and adjuvant therapy. Cases were also evaluated for incidence of major complications and incidence of tracheotomies.ResultsA total of 209 cases were assessed. Positive surgical margins after completion of surgical treatment and advanced neck disease were shown to be significant negative prognostic factors. The occult metastasis rate was 18.4%.ConclusionPrimary surgical treatment is a very effective modality against locally limited tonsillar carcinoma. Low rates of complications and permanent tracheotomies are to be expected.