TREATMENT OF OROPHARYNGEAL CARCINOMA BY IRRADIATION OR BY SURGERY

Of previously untreated patients with squamous cell carcinoma of the o ropharynx, 145 are reviewed in this study. All were treated in the Dep artment of Head and Neck Surgery at the University of Liverpool from 1 990 to 1997. Seventy-seven patients were treated with irradiation, 28 patients by surgery and 40 patients were deemed not suitable for any c urative treatment. Univariate analysis showed no difference in the two groups treated by curative modalities but multivariate analysis did s uggest that the surgical group tended to have larger neck node metasta ses. The 5-year tumour specific actuarial survival for all patients wa s 53%, 65% for the radiotherapy group and 51% for the surgery group. T he difference was not statistically significant (X-1(2) = 1.5070). The modality of treatment had no affect on either the development of a pr imary or neck node recurrence or the survival after such a recurrence. Where neck node disease was present it was treated as appropriate. As is generally standard practice, IS mph nodes over 2 cm were treated w ith radical neck dissection whether the patient was having irradiation therapy or surgery. If the patient was having irradiation therapy, th e neck dissection was carried out before and irradiation after operati on, both on the primary and on the neck, if appropriate. It is conclud ed that irradiation therapy in properly selected cases in combined hea d and neck clinics is a safe and effective treatment for squamous cell carcinoma of the oropharynx. Neck node disease should be treated appr opriately, but there is no support fur the old adage that whatever for m of treatment is being used for the neck node should also be used for the primary site.