Role of Tonsillectomy in the Management of Carcinomas of Unknown Primary of the Head and Neck: A Retrospective Study Based on p16 Analysis

Frontiers in Oncology

Julien Mancini¹  Pauline Podeur²  Nicolas Fakhry²  Laure Santini²  Antoine Giovanni²  Patrick Dessi²  Thomas Radulesco²  Justin Michel²  Sébastien Salas³  Jean Delgrande³  Stéphanie Wong⁴ 

[1] Aix-Marseille Univ, INSERM, IRD, APHM, UMR1252, SESSTIM, Department of Public Health (BIOSTIC), Hôpital de la Timone, Marseille, France;Department of Otorhinolaryngology, Head and Neck Surgery, Centre Hospitalier Universitaire la Conception, Assistance Publique–Hôpitaux de Marseille, Aix Marseille Univ, Marseille, France;Medical Oncology Department, Centre Hospitalier (CHU) La Timone, Marseille, France;Radiation Oncology Department, Hôpital Timone Adultes, Marseille, France;

关键词: unknown primary;    oropharyngeal cancer;    human papillomavirus;    head and neck cancer;    squamous cell carcinoma;   

DOI  :  10.3389/fonc.2020.594168

来源: DOAJ

【 摘 要 】

PurposeTo evaluate the impact of tonsillectomy on the detection of the primary tumor, based on p16 immunohistochemistry analysis, in patients with cervical unknown primary of squamous cell carcinoma (SCC-CUP).MethodsThis was a retrospective study of 63 patients, included from January 2008 to December 2017 in a single institution. All patients had an initial assessment with physical examination, CT scan of the neck and chest, whole body FDG-PET CT, and endoscopy under general anesthesia, which failed to determine the primary tumor.ResultsForty-seven out of the 63 patients had an ipsi- or bilateral tonsillectomy which revealed 12 tonsil cancers (26%). The tonsil primary was ipsilateral to positive nodes in 10 cases, contralateral in 1 case and, in 1 case, the patient had bilateral neck involvement. The analysis of the p16 status was carried out in 41/63 patients (65%). Among the 32 patients who had a p16 analysis and tonsillectomy, the rate of primary detection was 59% (10/17) for p16-postives and 0% (0/15) for p16-negatives (p < 0.001).ConclusionThese results suggest that an extended work-up should be systematically proposed including bilateral tonsillectomy (+/- mucosectomy of the base of tongue) in SCC-CUP p16-positive patients but not in p16-negatives.

【 授权许可】

Unknown