Abstract | IMPORTANCE: OBJECTIVE: DESIGN: Retrospective study of the SEER program. PARTICIPANTS: A total of 524 patients with stage I and II primary tonsil carcinoma diagnosed during the period 1988 through 2006 who received definitive radiation treatment. MAIN OUTCOMES AND MEASURES: Hazard ratios, 5-year disease-specific survival (DSS), 5-year overall survival (OS), and Kaplan-Meier survival curves. Subgroup univariate and multivariate analysis of survival compared the following variables: sex, T category (T1 vs T2), year of diagnosis (1988-2003 vs 2004-2006), and surgical status (preradiation tonsillectomy vs biopsy only). A log-rank test compared Kaplan-Meier survival analysis for the surgical status subgroups. RESULTS Statistically significant contributors to survival (DSS and OS) included age (P < .001, DSS), surgical status (P = .001, DSS), and year of diagnosis (P = .02, DSS). Treatment with radiation after tonsillectomy yielded a 5-year OS of 83% (95% CI, 77%-88%) and a 5-year DSS of 90% (95% CI, 84%-93%). This compares with an OS of 64% (95% CI, 54%-71%) and DSS of 76% (95% CI, 68%-82%) for radiation therapy after biopsy alone. CONCLUSIONS AND RELEVANCE: SEER data suggest that tonsil resection prior to radiation therapy is associated with improved survival in low-stage tonsil cancer. Although selection bias is a likely factor in this analysis, the effect remains after controlling for age and year of treatment.
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Authors | Michael A Holliday, Raluca Tavaluc, Tingting Zhuang, Hongkun Wang, Bruce Davidson |
Journal | JAMA otolaryngology-- head & neck surgery
(JAMA Otolaryngol Head Neck Surg)
Vol. 139
Issue 4
Pg. 362-6
(Apr 2013)
ISSN: 2168-619X [Electronic] United States |
PMID | 23599071
(Publication Type: Comparative Study, Journal Article)
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Topics |
- Adult
- Aged
- Female
- Humans
- Kaplan-Meier Estimate
- Male
- Middle Aged
- Morbidity
(trends)
- Neoplasm Staging
- Radiotherapy, Adjuvant
- Retrospective Studies
- SEER Program
- Survival Rate
(trends)
- Tonsillar Neoplasms
(epidemiology, radiotherapy, surgery)
- Tonsillectomy
- Treatment Outcome
- United States
(epidemiology)
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