The T category is based on the diameter of the primary tumor, without regard to the presence or absence of extratonsillar invasion. 4 - 6 The American Joint Committee on Cancer staging system for squamous cell carcinoma of the tonsil bases the T category on the size and extent of local spread to the cervical lymph nodes. 1 - 3 Recently, human papillomavirus (HPV) infection has been regarded as a new prognostic factor. Squamous cell carcinoma of the tonsil is a common head and neck cancer, and the prognosis is variable according to the tumor size and lymph node status. Five-year disease-specific survival was not significantly correlated with any clinicopathological factor in the multivariate analysis.Ĭonclusion Higher risk for multiple lymph node metastasis and 5-year locoregional recurrence seems to be predicted in patients with extratonsillar invasion of the pharyngeal constrictor muscle, even in early squamous cell carcinoma of the tonsil. Five-year disease-specific survival was significantly correlated with multiple lymph node metastasis (≥5 nodes) in the univariate analyses ( P = .009). No factor was correlated with 5-year locoregional recurrence in the multivariate analysis. Five-year locoregional recurrence was significantly correlated with invasion of the pharyngeal constrictor muscle ( P = .05) and with multiple lymph node metastasis (≥5 nodes) ( P = .04) in the univariate analyses. The rate of lymph node metastasis, the mean (SD) number of positive nodes, and the mean (SD) lymph node density were 81%, 5.47 (9.27), and 0.15 (0.22) in the invasive group, respectively, and 50%, 1.33 (1.72), and 0.04 (0.04) in the noninvasive group, respectively ( P = .04, P = .02, and P = .01, respectively). Results Invasion of the pharyngeal constrictor muscle was found in 36 patients (75%) with T2 squamous cell carcinoma of the tonsil. Main Outcome Measures Comparison of regional metastasis, 5-year locoregional recurrence, and 5-year disease-specific survival between the 2 groups. They were divided into 2 groups: an invasive group with invasion of the pharyngeal constrictor muscle and a noninvasive group without invasion of the pharyngeal constrictor muscle. Patients Forty-eight patients who were diagnosed as having T2 squamous cell carcinoma of the tonsil and who underwent surgery. Objective To determine whether invasion of the pharyngeal constrictor muscle in early squamous cell carcinoma of the tonsil is correlated with lymph node metastasis.ĭesign Retrospective analysis of medical records and pathology specimens.
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