Should Tonsillar Carcinoma With Nasopharynx Invasion Alone be Classified as a T4b Disease?

Abstract 

Objective

The aim of this study was to explore the role of nasopharynx (NP) invasion alone in tonsillar carcinoma.

Materials and Methods

From 1987 to 2005, 32 patients with unresect-able cT4b tonsillar carcinoma were retrospectively divided into two groups: the NP-only group, that included 11 patients with NP invasion alone without fitting other T4 criteria; and the other-T4b group, that included the remaining 21 patients. Local control and overall survival were the main endpoints of interest.

Results

At the time of this analysis, 28 patients had died, with a median follow-up time for all 32 patients of 13 months (range, 1-228 months). The mean follow-up period for the four living patients was 180 months (range, 125-228 months). When compared with the other T4b patients, patients with NP invasion alone, without fitting other T4 criteria, had greater 5-year local control (63.6% vs. 14.3%, p = 0.026; hazard ratio for local failure, 0.31; 95% confidence interval, 0.11-0.94) and 5-year overall survival (45.5% vs. 10.3%, p = 0.022; hazard ratio for death from any cause, 0.34; 95% confidence interval, 0.13-0.89).

Conclusion

In patients with tonsillar carcinoma, nasopharynx invasion alone should not be considered as an independent criterion of T4b classification in the next version of cancer staging.

Keywords:  Cancer stage , Concurrent chemoradiotherapy , Nasopharynx , Radiotherapy , Tonsillar carcinoma

No full text is available. To read the body of this article, please view the PDF online.