Primary surgical treatment of T2 oropharyngeal carcinoma.

BACKGROUND

The optimal management of oropharyngeal carcinoma (OPC) is not yet proven. The aim of this study is to analyze the outcome of primary surgical management of T2 cancers of the oropharynx.

METHODS

All patients treated with primary surgery for pT2 OPCs between 1984 and 2005 were evaluated retrospectively. Two hundred and twenty eight cases were assessed for disease-specific survival (DSS) as well as local control (LC) estimates, with respect to tumor location, surgical technique, status of surgical margins, N classification, and adjuvant therapy. Cases were also evaluated for major complications and functional results.

RESULTS

DSS was 73.2% and LC 88.9%. Carcinoma of the tonsils showed a significantly better DSS than lesions of the base of the tongue (DSS = 76.3 vs. 60.2%, P = 0.02). DSS estimates in patients with pN0-1 classification were significantly better in comparison with pN2-3 (83.6 vs. 64.5%, P = 0.018). Patients who were given adjuvant treatment had a better prognosis. The incidence of occult neck metastases was 17% and complications rate 12.7%.

CONCLUSIONS

Primary surgical treatment of T2 OPC proved to be an effective treatment modality with a low rate of complications and satisfactory functional results. Complete tumor excision is essential and a neck dissection is justified. Most patients need adjuvant radiotherapy.