The Effectiveness of Tonsillectomy in the Diagnostic Workup of Squamous Cell Carcinoma Unknown Primary in the Head and Neck Based on p16 Immunohistochemistry
2024

Effectiveness of Tonsillectomy for Unknown Primary Cancer in Head and Neck

Sample size: 66 publication Evidence: moderate

Author Information

Author(s): Stefanicka Patrik, Krupkova Katarina, Pavlovcinová Gabriela

Primary Institution: Department of Otorhinolaryngology-Head and Neck Surgery, Medical Faculty, Comenius University Bratislava

Hypothesis

The study aims to determine the effectiveness of palatine tonsillectomy in identifying primary tumors in p16-positive and p16-negative head and neck squamous cell carcinoma unknown primary patients.

Conclusion

Palatine tonsillectomy is effective in identifying primary cancer in p16-positive patients but not in p16-negative patients.

Supporting Evidence

  • Palatine tonsillectomy revealed tonsillar cancers in 15.4% of patients, all of whom were p16-positive.
  • No primary tonsillar tumor was found in the p16-negative group.
  • The identification rate of primary tumors in p16-positive patients using tonsillectomy was 27%.
  • Postoperative complications were minimal, with only one case of hemorrhage.

Takeaway

Doctors can find hidden cancers in the tonsils of some patients with neck tumors by removing the tonsils, especially if the cancer is linked to a virus called HPV.

Methodology

The study analyzed patients with head and neck squamous cell carcinoma unknown primary managed in two tertiary care centers from 2014 to 2020, focusing on the effectiveness of palatine tonsillectomy.

Potential Biases

Potential biases include the retrospective nature of the study and reliance on existing clinical data.

Limitations

The study is retrospective and may be influenced by institutional factors and the availability of clinical data.

Participant Demographics

Of the 66 patients, 55 (83.3%) were male and 11 (16.7%) were female, with a mean age of 61 years.

Statistical Information

P-Value

0.242

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.3390/medicina60121932

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