Roden DF, et al. – In order to gauge the impact of different treatment modalities on overall survival (OS), this work examined the National Cancer Data Base. Later this study unveiled greatest OS in patients with advanced stage SCC of the tonsil who underwent surgery followed by concurrent chemoradiation (CCRT). For a subset of patients with advanced stage tonsil cancer, triple–modality therapy may provide a survival benefit.

Methods

• The clinicians selected all patients aged ≤70 years diagnosed with clinical stage III to IVB (excluding T4B) SCC of the tonsil from 1998 through 2011.
• They suggested that analysis was limited to patients receiving CCRT, surgery plus CCRT, or surgery followed by adjuvant radiotherapy (RT).
• They compared OS using the Kaplan-Meier method and log-rank test.
• They conducted univariable and multivariable hazards analyses to identify factors significant for survival.
• They did propensity score matching.

Results

• 16,891 patients met the inclusion criteria.
• They highlighted that the most common treatment was CCRT (8123 patients; 48.1%), followed by surgery plus CCRT (5249; 31.1%) and surgery plus RT (3519 patients; 20.8%).
• In this study, patients treated with surgery plus CCRT were found to have the highest 3-year OS rate (88.5%) followed by those treated with surgery plus RT (84%) and CCRT (74.2%) (P<.0001).
• The 3-year OS rate was 90.2% for those treated with surgery plus CCRT, 84.9% for those treated with surgery plus RT, and 82.1% for those treated with definitive CCRT (P<.0001), in a propensity score-matched subpopulation of 4962 patients.