Surgery and/or Radiation Therapy

In a prospective randomized trial, 564 patients with head and neck cancer and N2 or N3 disease were assigned to either planned neck dissection or surveillance with positron emission tomography–computed tomography (PET-CT) scan.[2]

In a prospective randomized trial, 564 patients with head and neck cancer and N2 or N3 disease were assigned to either planned neck dissection or surveillance with positron emission tomography–computed tomography (PET-CT) scan.[2]

With a median follow up of 36 months, PET-CT surveillance resulted in fewer neck dissections compared with the surgical group (54 vs. 221), with a 2-year survival rate of 84.9% for the neck dissection group and 81.5% for the surgical group. The hazard ratio (HR) for death (HRdeath) slightly favored PET-CT−guided surveillance and indicated noninferiority (upper boundary 95% confidence interval [CI] for HR <1.50; P = .004).

A pooled analysis of 6,400 patients with base-of-the-tongue oropharyngeal carcinoma from 51 reported series between 1970 and 2000 demonstrated the following:[3]Historically, the posttreatment performance and functional status of patients with base-of-the-tongue primary tumors was better after radiation therapy than after surgery. Local control and survival are similar in both treatment options.[4,5]

A pooled analysis of 6,400 patients with base-of-the-tongue oropharyngeal carcinoma from 51 reported series between 1970 and 2000 demonstrated the following:[3]Historically, the posttreatment performance and functional status of patients with base-of-the-tongue primary tumors was better after radiation therapy than after surgery. Local control and survival are similar in both treatment options.[4,5]

Local control rates of 79% (surgery with or without radiation therapy) and 76% (radiation therapy alone), (P = .087); locoregional control was 60% for surgery with or without radiation therapy versus 69% for radiation therapy alone (P = .009).

A pooled analysis of 6,400 patients with base-of-the-tongue oropharyngeal carcinoma from 51 reported series between 1970 and 2000 demonstrated the following:[3]Historically, the posttreatment performance and functional status of patients with base-of-the-tongue primary tumors was better after radiation therapy than after surgery. Local control and survival are similar in both treatment options.[4,5]

The 5-year survival rate was 49% for surgery with or without radiation therapy versus 52% (P = .2) for radiation therapy with or without neck dissection.

A pooled analysis of 6,400 patients with base-of-the-tongue oropharyngeal carcinoma from 51 reported series between 1970 and 2000 demonstrated the following:[3]Historically, the posttreatment performance and functional status of patients with base-of-the-tongue primary tumors was better after radiation therapy than after surgery. Local control and survival are similar in both treatment options.[4,5]

The rate of severe complications was 32% for the surgery group versus 3.8% for the radiation therapy group (P < .001).

A pooled analysis of 6,400 patients with base-of-the-tongue oropharyngeal carcinoma from 51 reported series between 1970 and 2000 demonstrated the following:[3]Historically, the posttreatment performance and functional status of patients with base-of-the-tongue primary tumors was better after radiation therapy than after surgery. Local control and survival are similar in both treatment options.[4,5]

The rate of fatal complications was 3.5% for the surgery group versus 0.4% for the radiation therapy group (P < .001).

In the same study, the results for patients with squamous cell carcinoma (SCC) in the tonsillar region who underwent surgery with or without radiation therapy versus radiation therapy with or without neck dissection were as follows:[3]

In the same study, the results for patients with squamous cell carcinoma (SCC) in the tonsillar region who underwent surgery with or without radiation therapy versus radiation therapy with or without neck dissection were as follows:[3]

Local control rates of 70% (surgery with or without radiation therapy) and 68% (radiation therapy), (P = .2); locoregional control was 65% for surgery with or without radiation therapy versus 69% for radiation therapy alone (P = .1).

In the same study, the results for patients with squamous cell carcinoma (SCC) in the tonsillar region who underwent surgery with or without radiation therapy versus radiation therapy with or without neck dissection were as follows:[3]

The 5-year survival rate was 47% for surgery with or without radiation therapy versus 43% (P = .2) for radiation therapy with or without neck dissection.

In the same study, the results for patients with squamous cell carcinoma (SCC) in the tonsillar region who underwent surgery with or without radiation therapy versus radiation therapy with or without neck dissection were as follows:[3]

The rate of severe complications was 23% for the surgery group versus 6% for the radiation therapy group (P < .001)

In the same study, the results for patients with squamous cell carcinoma (SCC) in the tonsillar region who underwent surgery with or without radiation therapy versus radiation therapy with or without neck dissection were as follows:[3]

The rate of fatal complications was 3.2% for the surgery group versus 0.8% for the radiation therapy group (P < .001).