>Cirugía y Cirujanos
>Year 2003, Issue 4
Gallegos-Hernández JF, Cortés-Arroyo HD, Resendiz-Colosia JA, Torres-Patiño F, Barroso-Bravo S, Labastida-Almendaro S
Prognostic factors in oropharyngeal cancer
Cir Cir 2003; 71 (4)
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Introduction: Oropharyngeal carcinoma (OFC) is rare in Mexico, it only
represents 0.6% of all carcinomas. Treatment alternatives are radiotherapy
(RT) or radiotherapy-surgery association and prognosis depends on stage
and tumor location.
Objective: Our objective was to know prognostic factors in patients with
OFC treated with RT.
Material and methods: We conducted a retrospective analysis of patients
with OFC. Analyzed variables were tumor location, RT technique (with or
without field reduction; TRC and TSRC), tumor stage, histologic grade,
and macroscopic tumor type. Survival was estimated with Kaplan-Meier
Results: A total of 70 patients, median age of 62 years, 19 women and 51
men. Locations included 24 tonsil, 35 tongue base, eight soft palate,
and three posterior lateral wall. A total of 32 tumors were excrescent
and 38, ulcer infiltrating, 81% T3-T4 and 18% T1-T2. RT median dose was
5,625 rads; 51 were treated with TSRC and 19 with TRC. Local-regional
control was achieved in 35 patients (50%), mortality secondary to treatment
was 12.9% whit there were 5-year overall survival. Loco-regional recurrence
was 44%. Most frequent morbility for treatment was dysphagia (66%).
Variables with statistical survival significance were TRC (18% vs. 53%
p = 0.0012), stage (T1-2 vs. T3-4; 58% vs. 21% p = 0.0025, and tonsil
location (43% vs. 24% p < 0.005).
OFC diagnosis is usually made in advanced stages. Survival prognostic
factors are tumor location, tumor stage, and RT technique.
||Oropharyngeal cancer, prognostic factors.
Registro histopatológico de neoplasias en México. Población derechohabiente del IMSS 1993-1996. Rodríguez-Cuevas SA, Labastida S, Tapia R, Kuri P, Macías CG. 1st ed. México, D.F.: Ciencia y Cultura Latinoamericana; 1999.p.73.
Pradier R, Califano N. Cancer of the oropharynx (abstract). Proceedings of the International Meeting of the Society of Head and Neck Surgeons; 1996. Toronto, Canada.
Gluckman JL, Thompson R. Cancer of the oropharynx. In: Myers EN, Suen JY, editors. Cancer of the head and neck. 2nd ed. New York Churchil Livingstone; 1989.pp.465-494.
Marandas P, Wibault P. Cancers de l’oropharynx. Diplome de Carcinologie Cervico-Faciale. IGR. 1993-1994.pp.1-29.
Wasnik KS, Ughade SN, Zodpey SP, Ingole DL. Tobacco consumption and risk of oro-pharyngeal cancer: a case-control study in Centra India. Southeast Asian J Trop Med Public Health 1998;29:827-834.
Uzcudun AE, Bravo Fernández P, Sánchez JJ, et al. Clinical features of pharyngeal cancer: a retrospective study of 258 consecutive patients. J Laryngol Otol 2001;115:112-118
Johansen LV, Grau C, Overgaard J. Squamous cell carcinoma of the oropharynx: an analysis of treatment results in 289 consecutive patients. Acta Oncol 2000;39:985-994.
Lacosta JL, Calzada G, Infante JC, Remalle-Gomara E. Cancer of the tonsillar region. Retrospective study and review of the literature. Acta Otorrinolaringol Esp 2001;52:33-37.
Awasthy BS, Julka PK, Rath GK, Singh R. Simultaneous radiochemotherapy in the treatment of inoperable, locally advanced head and neck cancers. J Assoc Phys India 1998;46;261-262.
Schwager K, Hoppe F, Hagen R, Brunner FX. Outcome after resection of extensive oropharyngeal carcinomas and defect coverage by microvascular anastomosis of radials flap. Laryngorhinootologie 199;78:259-262.
Jackson SM, Hay JH, Flores AD, Weir L, Wong FL, Schwindt C, Baerg B. Cancer of the tonsil: the results of ipsilateral radiation treatment. Radiother Oncol 1999;51:123-128.
American Joint Committee on Cancer et Union Internationale Contre le Cancer: Manual for staging cancer, 3nd ed. 2nd rev. p.3.1992.
Million RR, Cassisi NJ, Mancuso AA. Oropharynx. In: Million RR, Cassisi NJ, Editors. Management of head and neck cancer. 2nd ed. Philadelphia PA, USA: J.B. Lippincott Co; 1984.p.401-429.
Kraus DH. Reconstruction of oropharyngeal defects. (abstract). Proceedings of the International Meeting of the Society of Head and Neck Surgeons (abstract). Toronto, Canada. 1996.
Institut Gustave Roussy. Protocole de traitement des cancers des vois aero-digestives superiores: carcinomes de la loge amygdalienne. 1991.
Moose BD, Kelly MD, Levine PA, et al. Definitive radiotherapy for T1 and T2 squamous cell carcinoma of the tonsil. Head Neck 1995;17:334-338.
Tiwari R. Surgical treatment of carcinoma of the tonsillar fossa, pharyngeal walls and soft palate (abstract). Proceedings of the International Meeting of the Society of Head and Neck Surgeons. Toronto, Canada. 1996.
Mantz CA, Vokes EE, Stenson K, Kies MS, Mittal B, Witt ME, List MA, Weichselbaum RR, Haraf DJ. Induction chemotherapy followed by concomitant chemoradiotherapy in the treatment of locoregionally advanced oropharyngeal cancer. Cancer J 2001;7:140-148.
Kokubo M, Nagata Y, Nishimura Y, Kimura H, Shoji K, Asato R, Sasai K, Hiraoka M. Concurrent chemoradiotherapy for oropharyngeal carcinoma. Am J Clin Oncol 2001;24:71-76.
Clayman GL, Johnson CJ 2nd, Morrison W, Ginsberg L, Lippman SM. The role of neck dissection after chemoradiotherapy for oropharyngeal cancer with advanced nodal disease. Arch Otolaryngol Head Neck Surg 2001;127:135-139.
Calais G, Alfonsi M, Bardet E, Sire C, Germain T, Bergerot P, Rhein B, Tortochaux J, Oudinot P, Bertrand P. Randomized trial of radiation therapy versus concomitant chemotherapy and radiation therapy for advanced-stage oropharynx carcinoma. J Natl Cancer Inst 1999;91:2081-2086.
Poulsen MG, Denham JW, Peters LJ, Lamb DS, Spry NA, Hindley A, Krawitz H, Hamilton C, Keller J, Tripcony L, Walker Q. A randomized trial of accelerated and conventional radiotherapy for stage III and IV squamous carcinoma of the head and neck: A Trans-Trasman Radiation Oncology Group Study. Radiother Oncol 2001;60:113-122.
Bentsen SM, Saunders MI, Dishe S, Bond SJ. Radiotherapy-related early morbidity in head and neck cancer: quantitative clinical radiobiology as deduced from the CHART Trial. Radiother Oncol 2001;60:123-135.
Magne N, Marcy PY, Chamorey F, Guardiola E, Pivot X, Schneider M, Demand F, Bensadoun RJ. Concomitant twice-a-day radiotherapy and chemotherapy in unresectable head and neck cancer patients: a long-term quality of life analysis. Head Neck 2001;23:678-682.
Calais G, Alfonsi M, Bardet E, et al. Stage III and IV cancers of the oropharynx: results of randomized study of Gortec comparing radiotherapy alone with concomitant chemotherapy. Bull Cancer 2000;87 Spec:48-53.
Domenge C, Hill C, Lefebvre JL, De Raucurt D, et al. Randomized trial of neoadjuvant in oropharyngeal carcinoma. French Groupe d’Etude des tumeurs de la tete et du Cou (GETTEC). Br J Cancer 2000;83:1594-1598.
Pignon JP, Bourhis J, Domenge C, Designe L. Chemotherpy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. Lancet 2000;355:949-955
>Cirugía y Cirujanos
>Year 2003, Issue 4