Combined surgery and radiation improves survival of tonsil squamous cell cancers
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Anurag K. Singh1, Christina Mimikos2, Adrienne Groman3, Shiva Dibaj3, Alexis J. Platek1, David M. Cohan2, Wesley L. Hicks Jr2, Vishal Gupta2, Hassan Arshad2, Moni A. Kuriakose2, Graham W. Warren4,5 and Mary E. Platek2,6
1Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA
2Department of Head and Neck/Plastic and Reconstructive Surgery, Roswell Park Cancer Institute, Buffalo, NY, USA
3Department of Biostatistics, Roswell Park Cancer Institute, Roswell Park Cancer Institute, Buffalo, NY, USA
4Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC, USA
5Department of Cell and Molecular Pharmacology, Medical University of South Carolina, Charleston, SC, USA
6Department of Health, Nutrition and Dietetics, Buffalo State College (SUNY), Buffalo, NY, USA
Anurag K. Singh, email: Anurag.Singh@Roswellpark.org
Keywords: tonsillar fossa, TORS, SCCHN, HPV, IMRT
Received: January 13, 2017 Accepted: July 31, 2017 Published: August 10, 2017
Objective: The study evaluated the addition of surgery (S) to radiation (RT) on survival of squamous cell carcinomas (SCC) of tonsillar-fossa (TF) in a modern cohort with similar epidemiology and treatment as current patients.
Study Design: Retrospective analysis utilizing Surveillance, Epidemiology, and End Results (SEER) Program data.
Results: For all stages combined TF patients who received S+RT had superior OS (p < 0.01) and DSS (p < 0.01). For each stage OS and DSS was superior for S+RT (p < 0.05). In multivariate analysis, HRs for OS were statistically significantly higher for TF patients (stage 2, 3, and 4) receiving RT alone (p < 0.001).
Materials and Methods: TF SCC patients treated with either S+RT or RT alone between 2004 and 2011 were examined (n = 6,476). Primary outcome measures included overall survival (OS) and disease specific survival (DSS). Cox proportional hazard ratios (HR) were estimated for patients treated with S+RT compared to RT alone.
Conclusions: OS and DSS were superior for all stages combined and for stages 2, 3, and 4 in TF patients who received S+RT compared to RT alone.
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