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

Moon-Sing Lee ； Yee-Min Jen ； Dai-Wei Liu ； Yu-Chieh Su ； Shih-Kai Hung ； Jing-Min Hwang ； Ching-Chih Lee ； Szu-Chi Li ； Wei-Ta Tsai ； Fong-Ling Chen ； Hon-Yi Lin

《慈濟醫學雜誌》 21卷3期 (2009/09) Pp. 204-209

並列摘要

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 unresectable 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.

並列關鍵字

Cancer stage ； Concurrent chemoradiotherapy ； Nasopharynx ； Radiotherapy ； Tonsillar carcinoma