Objective: Using propensity score matching method(PSM) to investigate the clinical effect of surgical plus radio(chemo)therapy and non-surgery chemoradiotherapy treatment strategies for advanced tonsillar squamous cell carcinoma. Methods: A retrospective analysis was conducted on the clinical data of 324 patients diagnosed with advanced tonsillar squamous cell carcinoma and treated in Peking Union Medical College Hospital from 2000 to 2018, confirmed by pathology and without distant metastasis. Survival analysis was performed using Kaplan-Meier estimates, the Cox proportional hazards model, and propensity score matching(PSM). Results: Of the 324 patients, 102 were treated with non-surgery chemoradiotherapy treatment strategies and 222 with surgical plus radio(chemo)therapy treatment. Cox multivariate analysis showed that the non-surgery treatment group had a favorable prognosis than the surgical treatment group, however, these outcomes were not significantly different [overall survival(OS): adjusted Hazard Ratios(aHR): 0.92, 95% confidence interval(CI): 0.60-1.42; disease-specific survival(DSS): aHR: 0.71, 95%CI: 0.43-1.20; disease-free survival(DFS): aHR: 0.82, 95%CI: 0.53-1.28]. The new patient cohort consisted of 102 subpairs after PSM. There were no significant differences between two groups(OS: aHR: 0.85, 95%CI: 0.51-1.40; DSS: aHR: 0.62, 95%CI: 0.35-1.11; DFS: aHR: 0.80, 95%CI: 0.49-1.33). Conclusion: Our findings indicate that patients with non-surgical treatment do not have significantly better survival outcomes compared to surgical treatment group, while non-surgical treatment has advantages in improving the quality of life of patients, so comprehensive treatment based on radiotherapy and chemotherapy may be recommended for advanced tonsillar squamous cell carcinoma.
Carcinoma, Squamous Cell/therapy* ; Chemoradiotherapy ; Humans ; Quality of Life ; Retrospective Studies ; Tonsillar Neoplasms/therapy*

OBJECTIVE: To investigate the clinical manifestation, immunophenotypes and prognostic factors of patients with primary tonsil afftive large B cell lymphoma ( PT-DLBCL ). METHODS: The clinical data including clinical characterstics, typing, staging, treatment efficacy and prognostic factors of PT-DLBCL patients were collected and analyzed restrospectively. RESULTS: Out of 36 cases with the detinite cell origin, 24 cases (66.7%) were detecmined as the type of germinal center B-cell (GCB) and 12 cases (33.3%) was non-germinal center B-cell (non-GCB), 15 (40.5%) out of 37 cases were in Ann Arbor stage Ⅰ, and 22 (59.5%) in stage Ⅱ. With the median follow-up of 44 (10-101) months, 2 cases (5.4%) failed to be followed-up, after treatment for 6 (3-8) cycles 35 patients were evaluated. Among them 26 cases (74.3%) reached to complete remission (CR), 8 cases (22.9%) to partial remission ( PR ), and 1 (2.8%) to stable disease (SD). Both the 3 years and 5 years progression-free survival ( PFS ) were 82.5%, and both 3 and 5 years overall survival (OS) were 95.5%. 5 cases (13.5%) received radiotherapy. The patients aged＞60 ( P＜0.05 ) or aged＞70 (P＜0.05) had shorter PFS than younger patients. The patients with increased lactic dehydrogenase ( LDH ) level (P＜0.01) and without rituximab (R) (P＜0.05) in the treatment regimen had relatively short OS. CONCLUSION The patients sensitive to chemotherapy and/or radiotherapy have a good prognosis. Most of the patients can obtain long-term survival after treatment. The effect of combined immunotherapy are better than that of the simple chemotherapy.
Aged ; Humans ; Lymphoma, Large B-Cell, Diffuse ; Middle Aged ; Palatine Tonsil ; Prognosis ; Tonsillar Neoplasms

OBJECTIVE: To evaluate the factors affecting long-term prognosis for dysphagia in tonsil cancer patients, after treatment. METHOD: This was a retrospective study of subjects who underwent a videofluoroscopic swallowing study (VFSS) following treatment for stage 3 or 4 tonsil cancer. Data including sex, age, cancer characteristics, and methods of cancer treatment were collected. To evaluate the swallowing-related outcome, we collected data including findings regarding the last VFSS, method of feeding, and history of aspiration pneumonia requiring in-patient care. We evaluated the correlation between these data and the characteristics of cancer and treatment methods. RESULT: Among 32 subjects included in this study, eight had aspiration or penetration confirmed by the last VFSS. There were no significant differences in swallowing-related factors according to the presence of aspiration or penetration in the last VFSS. Patients who underwent curative tonsillectomy retained more residues on the last VFSS than those who did not. CONCLUSION: Among subjects with tonsil cancer, history of curative tonsillectomy was correlated with more pharyngeal residue. However, other cancer- or treatment-related factors did not affect the outcome of swallowing.
Deglutition ; Deglutition Disorders ; Humans ; Methods ; Palatine Tonsil ; Pneumonia, Aspiration ; Prognosis ; Retrospective Studies ; Tonsillar Neoplasms ; Tonsillectomy

PURPOSE: The impact of postoperative ipsilateral neck radiotherapy (INRT) versus bilateral neck radiotherapy (BNRT) on the clinical outcomes of patients with tonsillar squamous cell carcinoma was analyzed retrospectively. MATERIALS AND METHODS: Between October 2001 and June 2012, 241 patients with T1-2 and N0-N2b tonsillar carcinoma from 16 institutes underwent postoperative INRT (n=84) or BNRT (n=157) following a tonsillectomy. Seventy patients were identified from each group by propensity score matching and compared in terms of the overall survival (OS), disease-free survival (DFS), locoregional relapse-free survival (LRRFS), and distant metastasis-free survival (DMFS) rates calculated using the Kaplan-Meier method with a log-rank test. RESULTS: The median follow-up was 55 months (range, 3 to 133 months). The survival outcomes in the INRT and BNRT groups were similar: 5-year OS (92.8% vs. 94.0%, p=0.985), DFS (80.5% vs. 94.2%. p=0.085), LRRFS (88.1% vs. 97.1%, p=0.083), and DMFS (92.7% vs. 97.0%, p=0.370). Subgroup analysis revealed no contralateral neck recurrence in 61 patients with T1-2N0-2a regardless of the treatment groups. For 79 patients with N2b, contralateral neck recurrence was more common in the INRT group than in the BNRT group (7.9% vs. 0.0%), but the difference was not significant (p=0.107). The overall grade ≥ 2 toxicities were lower in the INRT group: acute (45.7% vs. 74.3%, p=0.001) and late (4.3% vs. 31.4%, p < 0.001), respectively. CONCLUSION: INRT is an attractive strategy for patients with T1-2N0-2a tonsillar carcinoma compared to BNRT. For patients with N2b, there was a small risk of contralateral neck recurrence when treated with INRT, but its impact on the OS was limited with successful salvage treatment.
Academies and Institutes ; Carcinoma, Squamous Cell* ; Disease-Free Survival ; Epithelial Cells* ; Follow-Up Studies ; Humans ; Methods ; Neck* ; Palatine Tonsil* ; Propensity Score* ; Radiotherapy* ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Salvage Therapy ; Tonsillar Neoplasms ; Tonsillectomy

OBJECTIVES: The purpose is to provide detailed estimates of population-based incidences of head and neck cancers (HNCs) between 1999 and 2012 in South Korea and to evaluate trends. METHODS: Data was reviewed from the Korea National Cancer Incidence Database regarding the incidence of HNCs between 1999 and 2012. Locations that were surveyed included lip, oral tongue, oral cavity, major salivary gland, nasopharynx, nasal cavity and paranasal sinus, tonsil, hypopharynx, oropharynx, and larynx. Age-standardized incidence rates were calculated and provided with 95% confidence intervals. The increase ratio of HNCs for and male-to-female ratios were also calculated. RESULTS: The incidence of lip (0.07–0.10/100,000 people) and oropharyngeal cancer (0.09–0.12/100,000 people) remained low during the study period while laryngeal cancer (1.17–2.08/100,000 people) occurred most frequently. The incidence of oral tongue, major salivary gland, tonsil, and hypopharynx increased steeply compared to other HNCs between 1999 and 2012. Male-to-female ratio was over 1.0 for all HNCs, especially for those of tonsil, hypopharynx, oropharynx, and larynx cancer which were >5.0. CONCLUSION: The incidence of all the HNCs except for laryngeal cancer has increased yearly in men and women in South Korea since 1998. Rates of oral tongue, major salivary gland, and tonsil cancer have increased the most rapidly during this time period.
Female ; Head and Neck Neoplasms* ; Head* ; Humans ; Hypopharynx ; Incidence ; Korea* ; Laryngeal Neoplasms ; Larynx ; Lip ; Male ; Mouth ; Nasal Cavity ; Nasopharynx ; Neck ; Oropharyngeal Neoplasms ; Oropharynx ; Palatine Tonsil ; Republic of Korea ; Salivary Glands ; Tongue ; Tonsillar Neoplasms

The use of a myomucosal flap from the buccinator muscle is a valuable reconstruction method for intraoral defects. In this paper, we report the clinical advantages of using a buccinator myomucosal flap for the treatment of partial mandibular defects caused by osteoradionecrosis. We implemented a buccinator myomucosal flap for the reconstruction of a partial mandibular defect in a 55-year-old man with tonsil cancer and partial mandibular defects caused by osteoradionecrosis. The total operating time was 90 minutes. Twelve months after the reconstruction, the patient remains free of disease. A buccinator myomucosal flap can be used for the reconstruction of partial mandibular defects caused by osteoradionecrosis. It is a reliable method for reconstructing small mandibular defects.
Humans ; Mandible* ; Mandibular Reconstruction ; Middle Aged ; Myocutaneous Flap ; Osteoradionecrosis* ; Reconstructive Surgical Procedures ; Tonsillar Neoplasms

Branchiogenic carcinoma (BC), which is defined as squamous cell carcinoma arising from a branchial cyst, was first described by Volkmann in 1882. This rare disease is regarded as hypothetical, and remains a controversial disease entity. Among the diagnostic criteria of BC, the key point is the histologic demonstration of a cancer developing from the wall of an epithelial-lined cyst in the lateral site of the neck. In previous literature, many authors argued that this malignancy is actually cystic metastasis from oropharyngeal squamous cell carcinoma. We report a case of a 49-year-old female who was diagnosed as a primary BC patient with a synchronous tonsillar squamous cell carcinoma. Although this case did not meet the traditional diagnostic criteria because of existing tonsil cancer, we could diagnose these diseases as primary malignancies, since the transition zone was clearly seen, and there was no lymph node component in the histopathologic examination.
Branchioma ; Carcinoma, Squamous Cell* ; Epithelial Cells* ; Female ; Humans ; Lymph Nodes ; Middle Aged ; Neck ; Neoplasm Metastasis ; Neoplasms, Multiple Primary ; Palatine Tonsil* ; Rare Diseases ; Tonsillar Neoplasms

Grisel's syndrome, defined as the atlanto-axial joint subluxation not associated with a trauma or bone disease, is a rare complication following operative procedure and/or infections of the upper aerodigestive tract. Pathogenetically, it may occur in association with any condition that results in hyperemia and pathological relaxation of the transverse ligament of the atlanto-axial joint. When an inflammation heals, Grisel's syndrome can probably result in a fixation in the rotated position. It is diagnosed by physical and radiological findings. Early management, consisting of cervical immobilization and medical treatment, is considered a key factor for satisfactory outcome. Inappropriate treatment can result in a catastrophic consequence. Recently, we experienced a case of Grisel's syndrome following tonsillectomy in a patient with left palatine tonsillar cancer with preoperative radiotherapy. We report this case with a literature review.
Atlanto-Axial Joint* ; Bone Diseases ; Humans ; Hyperemia ; Immobilization ; Inflammation ; Ligaments ; Radiotherapy* ; Relaxation ; Surgical Procedures, Operative ; Tonsillar Neoplasms* ; Tonsillectomy*

Synchronous or metachronous head and neck cancer is known to occur in up to 20% of patients, negatively affecting long-term prognosis. We experienced a case of metachronous head and neck cancers in a Human papillomavirus (HPV)-positive patient without a history of smoking, initially presenting with as a cancer of unknown primary (CUP), and then with a contralateral tonsil cancer with metastatic lymphadenopathy five years later. This report highlights the clinical usefulness of HPV typing to determine the optimal extent of surgery and the follow-up strategy in CUP.
Carcinoma, Squamous Cell* ; Follow-Up Studies ; Head and Neck Neoplasms ; Head* ; Humans* ; Lymphatic Diseases ; Neck* ; Papilloma* ; Prognosis ; Smoke ; Smoking ; Tonsillar Neoplasms

Osteoradionecrosis is one of the most serious complications of patients receiving radiation therapy. It is characterized by hypovascularity, hypocellularity, and hypoxia-inducing necrosis of bone and soft tissue following delayed healing. In this case, a 72-year-old man was referred to the Department of Oral and Maxillofacial Surgery complaining of trismus following extraction three months before first visit. He had a history of right tonsillectomy, radical neck dissection and radiotherapy performed due to right tonsillar cancer seven years prior. After the diagnosis of osteoradionecrosis on right mandibular body and angle, conservative antibiotic therapy was used first, but an orocutaneous fistula gradually formed, and extensive bony destruction and sequestrum were observed. Sequestrectomy, free particulated iliac bone and umbilical fat pad graft were performed via a submandibular approach under general anesthesia. Preoperative regular exams and delicate wound care led to secondary healing of the wound without vascularized free flap reconstruction.
Adipose Tissue* ; Aged ; Anesthesia, General ; Diagnosis ; Fistula ; Free Tissue Flaps ; Head and Neck Neoplasms* ; Humans ; Jaw* ; Neck Dissection ; Necrosis ; Osteoradionecrosis* ; Radiotherapy ; Surgery, Oral ; Tonsillar Neoplasms ; Tonsillectomy ; Transplants* ; Trismus ; Wounds and Injuries