DISEASE-SPECIFIC SURVIVAL AND LOCOREGIONAL CONTROL IN TONSILLAR CARCINOMA

In a nationwide survey on oropharyngeal carcinoma in the Netherlands ( 1986-1990), 380 patients with a tonsillar carcinoma were retrospective ly studied. The records of 268 (71%) men and 112 (29%) women with a me dian age of 59 yr (range 31-91), who had squamous cell carcinoma (272 patients, 98%) or undifferentiated carcinoma (8 patients, 2%) were rev iewed with respect to treatment, disease-specific survival and locoreg ional control. Distribution by stage according to the UICC'92 system w as: 27 patients (7%) stage I, 59 (15%) stage II, 99 (26%) stage III, 1 82 (48%) stage IV and 13 patients (3%) unknown stage. Using a previous ly reported revised staging system the following distribution was obta ined: 118 patients (31%) stage I, 120 (31%) stage II, 67 (18%) stage I II, 54 (14%) stage IV and 21 patients (6%) with an unknown stage. Trea tment consisted of radiotherapy alone in 231 patients (61%), surgery a nd radiotherapy in 101 (27%), surgery alone in 30 (8%), chemotherapy i n 5 (2%) and 13 patients (3%) did not receive any treatment. At 5-yr t he overall survival was 32%, the disease-specific survival 42% and the locoregional control 61%. In patients treated with radiotherapy alone the disease-specific survival was 39%, for surgery and radiotherapy 5 3% and for surgery alone 83%. The disease-specific survival according to UICC'92 stage was 71% in stage I, 59% in II, 50% in III and 32% in stage IV (P < 0.0001). In the revised staging the survival figures wer e 63% in stage I, 43% in II, 31% in III and 9% in IV (P < 0.0001). The two staging systems appeared to be comparable in prognostic discrimin ation; the clinical relevance of the revised stage might, however, be slightly superior to the UICC'92 version. The difference in results af ter radiotherapy alone and surgery + radiotherapy remained significant , also after adjusting for stage (P < 0.0001).