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Bai C, He M, Li S, Liu J, Zhong L, Chen F, Zhou L, Jiang Y. Association between tonsillectomy and risk of oropharyngeal cancer: a systematic review. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2024; 44:143-149. [PMID: 38712770 PMCID: PMC11166217 DOI: 10.14639/0392-100x-n2790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/10/2024] [Indexed: 05/08/2024]
Abstract
Objective Studies have demonstrated that tonsillectomy may alter the risk of oropharyngeal cancer (OPC). We systematically reviewed the evidence and pooled data to examine such an association. Methods PubMed, Embase, and Scopus were searched up to 25th April 2023. Studies reporting an association between tonsillectomy and oropharyngeal cancer risk at any site were included. Results Five studies were eligible. All examined the risk of tonsillar and base of the tongue (BOT) cancer with prior history of tonsillectomy. On meta-analysis of the data, prior history of tonsillectomy was associated with a significantly decreased risk of tonsillar cancer. The second meta-analysis showed that history of tonsillectomy did not significantly alter the risk of BOT cancer. However, after exclusion of one study, the results showed an increased risk of BOT cancer with a history of tonsillectomy. Conclusions The scarce data available in the literature suggests that tonsillectomy may reduce the risk of tonsillar cancer but does not alter the risk of BOT cancer. Further studies are needed to explore the association between tonsillectomy and the risk of OPC.
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Affiliation(s)
- Chengxiang Bai
- Otolaryngology Head and Neck Surgery, Longquanyi District First People’s Hospital, Chengdu, China
| | - Mingfen He
- Otolaryngology Head and Neck Surgery, Longquanyi District First People’s Hospital, Chengdu, China
| | - Shuang Li
- Department of Pathology, Longquanyi District First People’s Hospital Chengdu, China
| | - Jing Liu
- Otolaryngology Head and Neck Surgery, Longquanyi District First People’s Hospital, Chengdu, China
| | - Linxiu Zhong
- Otolaryngology Head and Neck Surgery, Longquanyi District First People’s Hospital, Chengdu, China
| | - Feng Chen
- Otolaryngology Head and Neck Surgery, Longquanyi District First People’s Hospital, Chengdu, China
| | - Lanying Zhou
- Otolaryngology Head and Neck Surgery, Longquanyi District First People’s Hospital, Chengdu, China
| | - Yanfeng Jiang
- General Surgery Department, Longquanyi District First People’s Hospital, Chengdu, China
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Alharbi H, Saleh W, Yue S, Fernandes RP. Association between tonsillectomy and oropharyngeal cancer risk: a retrospective cohort study. Oral Maxillofac Surg 2024; 28:299-305. [PMID: 36790567 DOI: 10.1007/s10006-023-01139-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The purpose of this retrospective cohort study is to describe the association between the history of tonsillectomy and the risk of oropharyngeal squamous cell carcinoma (OPSSC), using a large cohort of patients. MATERIALS AND METHODS We performed a retrospective cohort study with 3620 patients diagnosed with OPٍSCC from 2010 to 2021. We utilized the University of Florida patients' registry i2b2 system. Three subsets of OPSSC were defined, base of tongue(BOT) cancer, tonsillar cancer, and other OPSSC. Tumor demographics and history of tonsillectomy were collected. Odds ratio for OPSSC were assessed utilizing a logistic regression model with adjusting for gender, race, and age. P < 0.05 was deemed significant. RESULTS Of the 3620 OPSSC patients were BOT cancer (N = 964), tonsillar cancer (N = 995), and other OPSSC (N = 1661). There was a statistically significant reduction in tonsillar cancer and BOT cancer odds ratio in patients with a history of tonsillectomy vs. patients without tonsillectomy (0.086 and 0.117), respectively, with a P value < .0001. The odds ratio of OPSSC in patients with a history of tonsillectomy vs. patients without tonsillectomy is 1.031. CONCLUSION This study showed that the OPSSC and previous history of tonsillectomy are associated. Our results showed a significant reduction in BOT and tonsillar cancer risk in patients with a history of tonsillectomy and an insignificant decrease in other OPSSC. This study could emphasize the importance of the development of future clinical trials to investigate the role of prophylactic tonsillectomy as a secondary preventive strategy to reduce OPSSC.
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Affiliation(s)
- Hamad Alharbi
- Department of Oral and Maxillofacial Surgery, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Wafaa Saleh
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Sijia Yue
- Department of Biostatistics, University of Florida, Gainesville, FL, 32611, USA
| | - Rui P Fernandes
- Division of Head and Neck Oncologic Surgery and Microvascular Reconstruction, Department of Oral and Maxillofacial Surgery, College of Medicine, University of Florida, Jacksonville, FL, 32225, USA
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Sethi S, Shahin A, Rahim INA. Association of Human Papillomavirus Infection with Tonsillar Cancers: A Systematic Review. Indian J Otolaryngol Head Neck Surg 2024; 76:268-276. [PMID: 38440648 PMCID: PMC10908725 DOI: 10.1007/s12070-023-04140-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/11/2023] [Indexed: 03/06/2024] Open
Abstract
Vaccinations have shown a decrease in human papillomavirus (HPV) infection-related cervical cancer in women, but there has been a sharp rise in the HPV infection-related oropharyngeal cancer cases over the past few decades. Recent studies have suggested the association of HPV infections with tonsillar cancers as well and suggestions regarding preventive tonsillectomies in order to achieve a decrease in HPV infection-related oropharyngeal or tonsillar cancer have arisen. However, there is limited cumulative evidence validated at a global level to support the endorsement of this strategy. This research revolves around the concept of burden of tonsillar carcinomas due to oropharyngeal HPV infection. Thus, a systematic review and meta-analysis of existing studies was undertaken to estimate the pooled prevalence of tonsillar cancer associated with oropharyngeal HPV infection. Published articles on tonsillar cancer with and without HPV infection from PubMed, Embase, Scopus and Web of Science were systematically searched from inception until 23 December 2021. A random-effects model was used to estimate the pooled prevalence forest plots. The systematic review revealed that 50% of the reported cases of tonsillar cancer had an oropharyngeal HPV infection, questioning the preventive nature of an early tonsillectomy which is essentially an invasive surgical procedure. Large heterogeneity was reported in the included studies, and there was insufficient data for sub-group analysis. Future research and representative studies are required to thoroughly explore the correlation between HPV infection and tonsillar cancer. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-04140-2.
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Affiliation(s)
- Sneha Sethi
- Australian Research Center for Population Oral Health, Adelaide Dental School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5000 Australia
| | - Alana Shahin
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA Australia
| | - Intisar Nuha Abd Rahim
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA Australia
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Liang J, Huang Y, Yin L, Sadeghi F, Yang Y, Xiao X, Adami HO, Ye W, Zhang Z, Fang F. Cancer risk following surgical removal of tonsils and adenoids - a population-based, sibling-controlled cohort study in Sweden. BMC Med 2023; 21:194. [PMID: 37226237 DOI: 10.1186/s12916-023-02902-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/16/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Removal of tonsils and adenoids is among the most common surgical procedures worldwide. Evidence of increased risk of cancer following such surgery is, however, inconclusive. METHODS We conducted a population-based, sibling-controlled cohort study of 4,953,583 individuals in Sweden with a follow-up during 1980-2016. History of tonsillectomy, adenotonsillectomy, and adenoidectomy was identified from the Swedish Patient Register whereas incident cases of cancer during follow-up were identified from the Swedish Cancer Register. We used Cox models to calculate hazard ratios (HR) with 95% confidence intervals (CI) of cancer in both a population and a sibling comparison. The sibling comparison was used to assess the potential impact of familial confounding, due to shared genetic or non-genetic factors within a family. RESULTS We found a modestly increased risk for any cancer following tonsillectomy, adenoidectomy, or adenotonsillectomy in both the population (HR 1.10; 95%CI 1.07-1.12) and sibling (HR 1.15; 95%CI 1.10-1.20) comparisons. The association did not differ greatly by type of surgery, age at surgery, or potential indication for surgery, and persisted more than two decades after surgery. An excess risk was consistently observed for cancer of the breast, prostate, thyroid, and for lymphoma in both population and sibling comparisons. A positive association was observed for pancreatic cancer, kidney cancer, and leukemia in the population comparison whereas a positive association was observed for esophageal cancer in the sibling comparison. CONCLUSIONS Surgical removal of tonsils and adenoids is associated with a modestly increased risk of cancer during the decades following the surgery. The association is unlikely attributed to confounding due to shared genetic or non-genetic factors with a family.
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Affiliation(s)
- Jinfeng Liang
- Department of Otolaryngology-Head & Neck Surgery, First Affiliated Hospital of Guangxi Medical University, 22# Shuangyong Road, Guangxi, 530021, Nanning, China
- Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumor (Guangxi Medical University), Ministry of Education, Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Guangxi Medical University, Nanning, Guangxi, China
| | - Yi Huang
- Department of Otolaryngology-Head & Neck Surgery, First Affiliated Hospital of Guangxi Medical University, 22# Shuangyong Road, Guangxi, 530021, Nanning, China
- Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumor (Guangxi Medical University), Ministry of Education, Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Guangxi Medical University, Nanning, Guangxi, China
| | - Li Yin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Fatemeh Sadeghi
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Yanping Yang
- Department of Otolaryngology-Head & Neck Surgery, First Affiliated Hospital of Guangxi Medical University, 22# Shuangyong Road, Guangxi, 530021, Nanning, China
- Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumor (Guangxi Medical University), Ministry of Education, Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Guangxi Medical University, Nanning, Guangxi, China
| | - Xue Xiao
- Department of Otolaryngology-Head & Neck Surgery, First Affiliated Hospital of Guangxi Medical University, 22# Shuangyong Road, Guangxi, 530021, Nanning, China
- Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumor (Guangxi Medical University), Ministry of Education, Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Guangxi Medical University, Nanning, Guangxi, China
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Clinical Effectiveness Group, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Zhe Zhang
- Department of Otolaryngology-Head & Neck Surgery, First Affiliated Hospital of Guangxi Medical University, 22# Shuangyong Road, Guangxi, 530021, Nanning, China.
| | - Fang Fang
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Lin ZJ, Huang L, Lin YM, Luo R, Wang SC, Lyu J, Shao J. Establishment of a Prognostic Nomogram for Cancer-Specific Survival in Patients With Base-of-Tongue Squamous Cell Carcinoma: A Retrospective Study Based on the SEER Database. Cancer Control 2023; 30:10732748231210733. [PMID: 37969067 PMCID: PMC10655788 DOI: 10.1177/10732748231210733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/16/2023] [Accepted: 10/02/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND The aim of this retrospective study was to construct and clinically apply a nomogram for cancer-specific survival (CSS) in patients diagnosed with base-of-tongue squamous cell carcinoma (BOTSCC) to predict their survival prognosis. METHODS We collected 8448 patients diagnosed with BOTSCC during 2004-2015 from the Surveillance, Epidemiology, and End Results (SEER) database and divided 30% and 70% of them into validation and training cohorts, respectively. We utilized backward stepwise regression in the Cox model to select variables. Predictive variables were subsequently identified from the variables selected above by using multivariate Cox regression. The new survival model was compared with the American Joint Committee on Cancer (AJCC) prognosis model using the following variables: calibration curve, time-dependent area under the receiver operating characteristic curve (AUC), concordance index (C-index), integrated discrimination improvement (IDI), decision-curve analysis (DCA), and net reclassification improvement (NRI). RESULTS A nomogram was established for predicting the CSS probability in patients with BOTSCC. Factors including sex, race, age at diagnosis, marital status, radiotherapy status, chemotherapy status, TNM AJCC stage, surgery status, tumor size, and months from diagnosis to treatment were selected through multivariate Cox regression as independent predictors of CSS. Calibration plots indicated that the model we established had satisfactory calibration ability. The AUC, C-index, IDI, DCA, and NRI results illustrated that the nomogram performed explicit prognoses more accurately than did the AJCC system alone. CONCLUSION We identified the relevant factors affecting the survival of BOTSCC patients and analyzed the data on patients suffering from BOTSCC in the SEER database. These factors were used to construct a new nomogram to give clinical staff a more-visual prediction model for the 3-, 5-, and 8-year probabilities of CSS for patients newly diagnosed with BOTSCC, thereby aiding clinical decision making.
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Affiliation(s)
- Zi-Jun Lin
- Department of Stomatology, Guangzhou Hospital of Integrated Traditional and West Medicine, Guangzhou, China
| | - Liying Huang
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Ying-Mei Lin
- Department of Stomatology, Guangzhou Hospital of Integrated Traditional and West Medicine, Guangzhou, China
| | - Renhui Luo
- Department of Stomatology, Guangzhou Hospital of Integrated Traditional and West Medicine, Guangzhou, China
| | - Shen-Chih Wang
- Department of Stomatology, Guangzhou Hospital of Integrated Traditional and West Medicine, Guangzhou, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Guangzhou, China
| | - Jun Shao
- Department of Stomatology, Guangzhou Hospital of Integrated Traditional and West Medicine, Guangzhou, China
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Geng C, Tian S, Song Q, Yang L, Li Y, Wang H, Tian X, Ge L. A New Approach for Evaluating Palatine Tonsillar Hypertrophy in Children Based on Ultrasound: A Pilot Study. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:3023-3029. [PMID: 35670148 DOI: 10.1002/jum.16030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 05/03/2022] [Accepted: 05/15/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To develop a novel ultrasound (US) plane to diagnose palatine tonsillar hypertrophy objectively in children. METHODS Tonsillar ultrasonography of children (age 2-14 years) who had a clinical diagnosis of tonsillar hypertrophy or not were analyzed retrospectively. Clinical data (including gender, age, body mass index (BMI)), and volume (V) of tonsils measured by the US, were recorded. Furthermore, we found a new US plane to diagnose tonsillar hypertrophy and named it the submental oblique cross-section. In this plane, diameters of the left tonsil, right tonsil, and central oropharynx were designated as T1, T2, and O. Then, we calculated the ratio by the formula (T1 + T2)/O. RESULTS A total of 172 cases (85 hypertrophy and 87 non-hypertrophy) were included in this study. There were no significant differences in gender (P = .844), age (P = .666), and BMI (P = .089) between the groups. In the non-hypertrophy group, the V of both sides had a positive linear correlation with age or BMI. In contrast, there was no linear correlation between ratio and age or BMI. The area under the curve (AUC) of ratio and V was 0.970 (95%CI: 0.947-0.993) and 0.835 (95%CI: 0.778-0.893) by receiver operating characteristic (ROC) analysis, respectively. The optimal cutoff value of ratio for diagnosis of tonsillar hypertrophy was 2.293 (sensitivity = 88.2%, specificity = 95.4%). CONCLUSIONS We established a new US section to evaluate tonsillar hypertrophy. This approach could be easily acquired and provide a reference value to guide clinical practice.
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Affiliation(s)
- Chenchen Geng
- Department of Ultrasound, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Shuxu Tian
- Department of Gynecology, Qingdao Women and Children's Hospital, Qingdao University, Qingdao, China
| | - Qian Song
- Department of Ultrasound, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Liu Yang
- Department of Ultrasound, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Ye Li
- Department of Radiology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Huihui Wang
- Department of Ultrasound, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Xueping Tian
- Department of Pediatrics, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Ling Ge
- Department of Ultrasound, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
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Samdani SK, Kishore J, Yogi V, Sharma S, Amreen. A Comparative Study of Cold Dissection Tonsillectomy and Harmonic Scalpel Tonsillectomy Under Microscope- Our Experience. Indian J Otolaryngol Head Neck Surg 2022; 74:5395-5403. [PMID: 36742737 PMCID: PMC9895539 DOI: 10.1007/s12070-021-02586-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 04/26/2021] [Indexed: 02/07/2023] Open
Abstract
Tonsillectomy is one of the most common proceduresin routine otolaryngology.Given that the pediatric demographic is usually in question, ENT surgeons are resorting to newer modalities that minimize the dreaded complication of intra-operative and post-operative hemorrhage and have shorter operative time. The present study was conducted on patients admitted in ward in the Department of Otorhinolaryngology at SMS Medical College and Hospital, JaipurFrom July 2019 to June 2020 on a sample size of 40 patient diagnosed as adeno-tonsillar hypertrophy of grade 3-4. Each patient underwent tonsillectomy by cold dissection method on one side and by ultrasonic scalpel on other. The present study was conducted on patients admitted in ward in the Department of Otorhinolaryngology at SMS Medical College and Hospital, JaipurFrom July 2019 to June 2020 on a sample size of 40 patient diagnosed as adeno-tonsillar hypertrophy of grade 3-4. Each patient underwent tonsillectomy by cold dissection method on one side and by ultrasonic scalpel on other. In our study Mean operation time, mean blood loss, Analogue score for post-operative pain at 24hrs and 7th postoperative day respectively and Healing of wound on 14th post-operative day were significantly lower in cases of tonsillectomy with harmonic scalpel than cold dissection method tonsillectomy. The novel technique of tonsillectomy harmonic scalpel is proven to be better with regard to lesser operative time, blood loss and lesser post-operative morbidity.
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Affiliation(s)
- Sunil Kumar Samdani
- Departmen of Otorhinolaryngology and Head and Neck Surgery, SMS Medical College, Jaipur, India
| | - Jugal Kishore
- Departmen of Otorhinolaryngology and Head and Neck Surgery, SMS Medical College, Jaipur, India
| | - Vipasha Yogi
- Departmen of Otorhinolaryngology and Head and Neck Surgery, SMS Medical College, Jaipur, India
- 20, Brijlalpura Scheme, Santosh Nagar, Opp Ganga Jamuna Petrol Pump,Gopalpura By Pass, Jaipur, 302019 India
| | - Sanjay Sharma
- Departmen of Otorhinolaryngology and Head and Neck Surgery, SMS Medical College, Jaipur, India
| | - Amreen
- Departmen of Otorhinolaryngology and Head and Neck Surgery, SMS Medical College, Jaipur, India
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Wu FM, Yu AJ, Choi JS, Swanson MS, Chambers TN, Kokot NC, Sinha UK. Human papillomavirus detection in oral rinses and history of tonsillectomy in U.S. adults. Am J Otolaryngol 2022; 43:103558. [PMID: 36029622 DOI: 10.1016/j.amjoto.2022.103558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/20/2022] [Accepted: 07/31/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE This study aims to elucidate any relationship between prior tonsillectomy and the presence of oropharyngeal HPV DNA found in screening mouth rinses. MATERIALS AND METHODS A cross sectional study was conducted using the 2011-2014 National Health and Nutrition Examination Survey (NHANES). Participants between 40 and 69 were included in the study and medical, surgical, and sexual health history were recorded. Multivariable analyses were conducted to examine factors associated with HPV prevalence in oral rinse samples. RESULTS A total of 4825 participants were recorded with 21.1 % having a history of tonsillectomy. In the no tonsillectomy group, 8.6 % of respondents had a positive oral rinse for HPV, while 7.2 % of those with a tonsillectomy had a positive rinse sample. There was no association between age and HPV prevalence (OR = 1.04, 95 % CI: [1.00-1.07]). When controlling for demographics, medical history, and sexual behaviors, tonsillectomy history was not shown to have an association with HPV (OR = 0.86, 95 % CI: [0.53-1.40]). However, men, Hispanics, smokers, and those with higher lifetime sexual partners had increased odds of having a positive HPV oral rinse sample which was statistically significant. CONCLUSION Our data showed that a history of tonsillectomy was not significantly associated with the presence of HPV in an oral rinse. However, a significant relationship was seen between the presence of HPV in oral rinses and certain demographic factors such as male gender, Hispanic race, smoking history, and increased sexual partners.
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Affiliation(s)
- Franklin M Wu
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
| | - Alison J Yu
- Tina and Rick Caruso Department of Otolaryngology Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Janet S Choi
- Tina and Rick Caruso Department of Otolaryngology Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Mark S Swanson
- Tina and Rick Caruso Department of Otolaryngology Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Tamara N Chambers
- Tina and Rick Caruso Department of Otolaryngology Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Niels C Kokot
- Tina and Rick Caruso Department of Otolaryngology Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Uttam K Sinha
- Tina and Rick Caruso Department of Otolaryngology Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
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Epidemiology and Prevention of HPV-Associated Squamous Cell Carcinoma. CURRENT OTORHINOLARYNGOLOGY REPORTS 2022. [DOI: 10.1007/s40136-021-00385-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Tonsillectomy and the incidence of various types of cancer. Immunol Res 2021; 69:467-470. [PMID: 34523058 PMCID: PMC8580919 DOI: 10.1007/s12026-021-09230-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/28/2021] [Indexed: 11/03/2022]
Abstract
A potential connection between tonsillectomy and the development of various cancer types has repeatedly been reported in the scientific literature, but many studies have contradicted these observations. Thus, we have no clear evidence, neither to firmly support nor to refute the above-mentioned connection. Here, I suggest that the main reason for the lack of clearer evidence is that the investigations have so far mainly used incorrect sample groups. I propose that individual differences in the tonsils' involvement in immune reactions should be taken into account to solve this long-standing puzzle.
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Windon MJ, Fakhry C, Margalit DN, Dey T, Rettig EM. Epidemiologic distinctions between base of tongue and tonsil oropharyngeal carcinomas. Head Neck 2021; 43:3076-3085. [PMID: 34288202 DOI: 10.1002/hed.26804] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 05/13/2021] [Accepted: 06/28/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV)-positive tonsil and base of tongue (BOT) cancers have been considered together. However, important differences may exist. METHODS Demographic and tumor characteristics, and survival, were compared by oropharyngeal cancer subsite from 2004 to 2016 in the National Cancer Database (NCDB). Trends in tonsillectomy from the National Health and Nutrition Examination Survey (NHANES) 2011-2014 were examined. RESULTS HPV-positive BOT (N = 13 081) were older than HPV-positive tonsil patients (N = 16 874; mean 61.5 vs. 58.4 years, p < 0.001), and individuals 70+ years were significantly more likely to have BOT tumors compared with individuals <50 (adjusted odd ratio [aOR] = 2.9, 95% confidence interval = 2.6-3.2). BOT patients were also more likely to be white, male, and have advanced tumor classification. Among 7418 NHANES participants, tonsillectomy was associated with older age and white race. CONCLUSIONS There are epidemiologic and tumor-related differences among HPV-positive tonsil and BOT carcinomas. Demographic differences may be attributable to tonsillectomy trends.
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Affiliation(s)
- Melina J Windon
- Department of Otolaryngology Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Carole Fakhry
- Department of Otolaryngology Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Bloomberg~Kimmel Institute for Cancer Immunotherapy, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Danielle N Margalit
- Department of Radiation Oncology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Head and Neck Oncology Program, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Tanujit Dey
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Eleni M Rettig
- Head and Neck Oncology Program, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Division of Otolaryngology, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Oropharyngeal squamous cell carcinoma diagnoses following resolution of isolated cervical lymphadenitis, a case series. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2021. [DOI: 10.1016/j.adoms.2021.100108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Combes JD, Voisin N, Périé S, Malard O, Jegoux F, Nadjingar R, Buiret G, Philouze P, Garrel R, Vergez S, Fakhry N, Righini C, Mirghani H, Lerat J, Saroul N, Verillaud B, Bartaire E, Céruse P, Clifford GM, Franceschi S, Lacau St Guily J. History of tonsillectomy and risk of oropharyngeal cancer. Oral Oncol 2021; 117:105302. [PMID: 33905915 DOI: 10.1016/j.oraloncology.2021.105302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 04/06/2021] [Accepted: 04/08/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate whether palatine tonsillectomy in youth influences the risk of oropharyngeal cancers (OPC) by assessing the association between history of tonsillectomy and risk of tonsillar, base of tongue (BOT) cancer, and other head and neck cancers (HNC). MATERIALS AND METHODS RACKAM was a case-case study comparing frequency of tonsillectomy history in individuals diagnosed with HNC from 2013 to 2018 in 15 centers across France. History of tonsillectomy was defined using combined assessment of patients' recollections and surgeons' visualizations of tonsil area. OPC subsite-specific odds ratios (OR) of tonsillectomy were calculated using multinomial logistic regression with non-oropharyngeal HNC as reference. RESULTS 1045 patients were included in the study. Frequency of tonsillectomy was 19.5% in patients with tonsillar cancer (N = 85), 49.3% in BOT (N = 76), 33.8% in other oropharyngeal cancers (N = 202) and 38.0% in non-oropharyngeal HNC (N = 682). History of tonsillectomy was inversely associated with tonsillar cancer (adjusted OR 0.4; 95% CI 0.2-0.8), and positively associated with BOT cancer (adjusted OR 1.8; 95% CI 1.1-3.1), but was not associated with all OPC combined (adjusted OR 1.1; 95% CI 0.8-1.4). Sensitivity analyses considering only patients' or surgeons' assessments of tonsillectomy provided comparable results. CONCLUSION We confirm the long-term protective effect of tonsillectomy performed in youth on future risk of tonsillar cancer, and our study is the second to report a concurrent increased risk of BOT cancer. Our data suggest that tonsillectomy in youth shifts the site of the first diagnosed oropharyngeal tumor and has a limited impact on overall risk of OPC.
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Affiliation(s)
- Jean-Damien Combes
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer (IARC/WHO), 69372 Lyon Cedex 08, France.
| | - Nicolas Voisin
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer (IARC/WHO), 69372 Lyon Cedex 08, France; Department of Otolaryngology-Head and Neck Surgery, Croix Rousse Hospital, Service d'ORL et chirurgie cervico-faciale, Hospices Civils de Lyon (Hospital Group of Lyon), 69004 Lyon, France.
| | - Sophie Périé
- Department of Otolaryngology Head Neck Surgery, Faculty of Medicine Sorbonne University, Tenon Hospital, Assistance Publique Hôpitaux Paris (APHP), Paris, France; Department of Otolaryngology Head and Neck Surgery, COM CCF Maillot, Hartmann Clinic, 92200 Neuilly sur Seine, France
| | - Olivier Malard
- Department of Otorhinolaryngology and Head and Neck Surgery, Nantes University Hospital, 44036 Nantes, France.
| | - Franck Jegoux
- Department of Otorhinolaryngology and Head and Neck Surgery, Rennes University Hospital, 35000 Rennes, France.
| | | | - Guillaume Buiret
- Department of Ear, Nose, and Throat, Valence Hospital, 26000 Valence, France.
| | - Pierre Philouze
- Department of Otolaryngology-Head and Neck Surgery, Croix Rousse Hospital, Service d'ORL et chirurgie cervico-faciale, Hospices Civils de Lyon (Hospital Group of Lyon), 69004 Lyon, France.
| | - Renaud Garrel
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Montpellier, 34000 Montpellier, France.
| | - Sébastien Vergez
- Head and Neck Surgery Department, Toulouse University Hospital Center, University Cancer Institute of Toulouse Oncopôle, 31000 Toulouse, France.
| | - Nicolas Fakhry
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Center la Conception, Assistance Publique - Hôpitaux de Marseille, Aix Marseille University, Marseille, France.
| | - Christian Righini
- Department of Otolaryngology-Head and Neck Surgery, Grenoble University Hospital, 38000 Grenoble, France.
| | - Haitham Mirghani
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 94800 Villejuif, France.
| | - Justine Lerat
- Department of ENT Surgery, Limoges University Hospital, 87000 Limoges, France.
| | - Nicolas Saroul
- Head and Neck Surgery Department, Clermont-Ferrand University Hospital, 63000 Clermont-Ferrand, France.
| | - Benjamin Verillaud
- Department of Otolaryngology Head Neck Surgery, Lariboisière Hospital, Assistance Publique Hôpitaux Paris (APHP), Inserm U1141, Paris University, Paris, France
| | - Emmanuel Bartaire
- Department of Otorhinolaryngology and Head and Neck Surgery, Faculté Libre de Médecine de Lille, GHICL Saint-Vincent-de-Paul Hospital, 59000 Lille, France.
| | - Philippe Céruse
- Department of Otolaryngology-Head and Neck Surgery, Croix Rousse Hospital, Service d'ORL et chirurgie cervico-faciale, Hospices Civils de Lyon (Hospital Group of Lyon), 69004 Lyon, France.
| | - Gary M Clifford
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer (IARC/WHO), 69372 Lyon Cedex 08, France.
| | - Silvia Franceschi
- Centro di Riferimento Oncologico (CRO), IRCCS, 33081 Aviano, PN, Italy.
| | - Jean Lacau St Guily
- Department of Otolaryngology Head Neck Surgery, Faculty of Medicine Sorbonne University, Tenon Hospital, Assistance Publique Hôpitaux Paris (APHP), Paris, France; Department of Otolaryngology Head Neck Surgery, Rothschild Foundation, 75019 Paris, France
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14
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Garman KS, Ajayi TA, Boutte HJ, Chiu ST, von Furstenberg RJ, Lloyd BR, Zhang C, Onaitis MW, Chow SC, McCall SJ. Prior tonsillectomy is associated with an increased risk of esophageal adenocarcinoma. PLoS One 2020; 15:e0235906. [PMID: 32697782 PMCID: PMC7375530 DOI: 10.1371/journal.pone.0235906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 06/03/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Esophageal cancer is a deadly cancer with 5-year survival <20%. Although multiple risk factors for esophageal adenocarcinoma (EAC) including obesity, GERD and smoking have been identified, these risk factors do not fully explain the rising incidence of EAC. In this study, we evaluated the association between prior history of tonsillectomy and EAC. Our goal was to determine whether tonsillectomies were more frequent in patients with EAC (cases) than in our thoracic surgery controls. METHODS Cases included 452 esophagectomy cases, including 396 with EAC and 56 who underwent esophagectomy for Barrett's esophagus (BE) with high grade dysplasia (HGD). 1,102 thoracic surgery patients with surgical indications other than dysplastic BE or esophageal cancer represented the controls for our analysis. The association of tonsillectomy and HGD/EAC were primarily evaluated by using univariate tests and then verified by logistic regression analysis. Baseline demographics, medical history, and thoracic surgery controls were compared by using χ2 tests or 95% CIs. Significant risk factors were considered as covariates in the multivariate models while evaluating the association between tonsillectomy and HGD/EAC. P-values or odds ratios were estimated with 95% confidence limits to identify significances which was more appropriate. RESULTS Tonsillectomy was more common in cases than controls and was found to have a significant association with esophageal cancer (19.9% vs. 12.7%; p-value = 0.0003). This significant association persisted after controlling for other known risk factors/covariates. CONCLUSION A prior history of tonsillectomy was significantly associated with HGD/EAC and may represent an independent risk factor for the development of EAC. However, the underlying biology driving this association remains unclear.
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Affiliation(s)
- Katherine S. Garman
- Division of Gastroenterology, Department of Medicine, Duke University, Durham, North Carolina, United States of America
| | - Teminioluwa A. Ajayi
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Harold J. Boutte
- Division of Gastroenterology, Department of Medicine, Northwestern Medicine, Chicago, Illinois, United States of America
| | - Shih-Ting Chiu
- Providence Health and Services, Portland, Oregon, United States of America
| | - Richard J. von Furstenberg
- Division of Gastroenterology, Department of Medicine, Duke University, Durham, North Carolina, United States of America
| | - Benjamin R. Lloyd
- Division of Gastroenterology, Department of Medicine, Duke University, Durham, North Carolina, United States of America
| | - Cecelia Zhang
- Division of Gastroenterology, Department of Medicine, Duke University, Durham, North Carolina, United States of America
| | - Mark W. Onaitis
- Division of Cardiovascular and Thoracic Surgery, Department of Surgery, University of California San Diego, La Jolla, California, United States of America
| | - Shein-Chung Chow
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, United States of America
| | - Shannon J. McCall
- Department of Pathology, Duke University, Durham, North Carolina, United States of America
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15
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Kreimer AR, Shiels MS, Fakhry C, Johansson M, Pawlita M, Brennan P, Hildesheim A, Waterboer T. Screening for human papillomavirus-driven oropharyngeal cancer: Considerations for feasibility and strategies for research. Cancer 2018; 124:1859-1866. [PMID: 29499070 DOI: 10.1002/cncr.31256] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 12/20/2017] [Accepted: 12/22/2017] [Indexed: 01/04/2023]
Abstract
The incidence and burden of human papillomavirus (HPV)‐driven oropharyngeal cancer is expected to increase for decades, thus motivating discussions regarding possibilities for screening. This article addresses issues related to the validity and timeliness of screening for HPV‐driven oropharyngeal cancer, and raises important questions, highlights deficits and confusion in the existing literature, and proposes needed steps in the research agenda.
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Affiliation(s)
- Aimée R Kreimer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Meredith S Shiels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Carole Fakhry
- Head and Neck Surgery, Department of Otolaryngology, Johns Hopkins University, Baltimore, Maryland
| | | | - Michael Pawlita
- Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer Program, German Cancer Research Center, Heidelberg, Germany
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Allan Hildesheim
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Tim Waterboer
- Infections and Cancer Epidemiology, Infection, Inflammation and Cancer Program, German Cancer Research Center, Heidelberg, Germany
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Kim K, Choi KY, Kim JH, Park IS, Rho YS, Lee DJ. Base of tongue cancer-is it tongue cancer located at the base of the tongue, or is it a type of lingual tonsil cancer? The perspective from a genomic analysis. Int J Oral Maxillofac Surg 2018; 47:846-853. [PMID: 29452725 DOI: 10.1016/j.ijom.2018.01.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 12/05/2017] [Accepted: 01/26/2018] [Indexed: 11/26/2022]
Abstract
The aim of this study was to determine whether base of tongue (BOT) cancer is tongue cancer located at the base of the tongue or lingual tonsil cancer originating from tonsil tissue. This was a retrospective study using data from The Cancer Genome Atlas (TCGA). The genomic patterns of three primary cancers (BOT, oral tongue, and tonsil) were compared to determine their similarities and differences. Gene expression data (n=193; 26 BOT, 125 oral tongue, and 42 tonsil cases), copy number alteration data (n=142; 19 BOT, 96 oral tongue, and 27 tonsil cases), and somatic mutation data (n=187; 25 BOT, 122 oral tongue, and 40 tonsil cases) were analyzed using the t-test, heatmap analysis, and OncoPrint, respectively. Clinical information for the three tumour groups was included in the analyses. When using multiplatform analysis, BOT cancer showed nearly the same genomic pattern as tonsil cancer, but not oral tongue cancer. The χ2 test and survival analysis revealed that BOT cancer had the same clinical and survival patterns as tonsil cancer. In conclusion, BOT cancer showed a genomic pattern similar to that of tonsil cancer, but different to that of oral tongue cancer. Further prospective studies are warranted before the results of this study can be applied in a clinical setting.
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Affiliation(s)
- K Kim
- Department of Otolaryngology-Head and Neck Surgery, Hallym University Medical Centre, Seoul, Republic of Korea
| | - K Y Choi
- Department of Otolaryngology-Head and Neck Surgery, Hallym University Medical Centre, Seoul, Republic of Korea
| | - J H Kim
- Department of Otolaryngology-Head and Neck Surgery, Hallym University Medical Centre, Seoul, Republic of Korea
| | - I S Park
- Department of Otolaryngology-Head and Neck Surgery, Hallym University Medical Centre, Seoul, Republic of Korea
| | - Y S Rho
- Department of Otolaryngology-Head and Neck Surgery, Hallym University Medical Centre, Seoul, Republic of Korea
| | - D J Lee
- Department of Otolaryngology-Head and Neck Surgery, Hallym University Medical Centre, Seoul, Republic of Korea.
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Huang SH, O'Sullivan B, Waldron J. The Current State of Biological and Clinical Implications of Human Papillomavirus-Related Oropharyngeal Cancer. Semin Radiat Oncol 2018; 28:17-26. [DOI: 10.1016/j.semradonc.2017.08.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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18
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Turner MT, Byrd JK, Ferris RL. Current Role of Surgery in the Management of Oropharyngeal Cancer. J Oncol Pract 2017; 12:1176-1183. [PMID: 27858544 DOI: 10.1200/jop.2016.015263] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The 1990s saw an increased use of chemoradiotherapy protocols, commonly referred to as organ-sparing therapy, for the treatment of oropharyngeal cancer after the Groupe d'Oncologie Radiothérapie Tête et Cou trial. Since that time, human papillomavirus-associated oropharyngeal squamous cell carcinoma has been identified as a unique disease, with improved survival regardless of treatment modality. The improved outcomes of this population has led to re-evaluation of treatment paradigms in the past decade, with a desire to spare young, human papillomavirus-positive patients the treatment-related toxicities of chemoradiotherapy and to use new minimally invasive surgical techniques to improve outcomes. Numerous retrospective and prospective studies have investigated the role of surgery in treatment of oropharyngeal carcinoma and have demonstrated equivalent oncologic outcomes and improved functional outcomes compared with chemoradiotherapy protocols. Ongoing and future clinical trials may help delineate the role of surgery in the future.
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Affiliation(s)
- Meghan T Turner
- University of Pittsburgh Medical Center, Pittsburgh, PA; and Medical College of Georgia at Augusta University, Augusta, GA
| | - J Kenneth Byrd
- University of Pittsburgh Medical Center, Pittsburgh, PA; and Medical College of Georgia at Augusta University, Augusta, GA
| | - Robert L Ferris
- University of Pittsburgh Medical Center, Pittsburgh, PA; and Medical College of Georgia at Augusta University, Augusta, GA
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19
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Theodoraki MN, Veit JA, Hoffmann TK, Greve J. Synchronous bilateral tonsil carcinoma: case presentation and review of the literature. Infect Agent Cancer 2017; 12:38. [PMID: 28670333 PMCID: PMC5485684 DOI: 10.1186/s13027-017-0146-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 06/11/2017] [Indexed: 12/05/2022] Open
Abstract
Background The incidence of synchronous bilateral tonsil carcinoma seems to be underreported. For adequate oncologic treatment, it is mandatory to remove all primaries to prevent recurrence or metachronic disease. The purpose of this manuscript is to provide a comprehensive review on this topic and to emphasize the need of bilateral tonsillectomy in cases of cancer of unknown primary (CUP) as well as in the case of a unilateral tonsillar carcinoma. Material and methods A systematic review of the literature was performed for “bilateral tonsillar neoplasm”, “synchronous cancer of the oropharynx” and “cancer of unknown primary in head and neck”. Results We present a clinical case with bilateral tonsillar carcinoma in initially suggested cancer of unknown primary. Clinically, both tonsillar sites were unsuspicious, but in PET/CT an ipsilateral enhancement of the tonsil area was detected. The pathological work up of bilateral tonsillectomy specimens revealed bilateral squamous cell carcinoma with HPV-type 16 positivity. The review of the literature revealed 29 cases of bilateral tonsil cancer. Conclusion The handling of tonsillar tissue in the frame of panendoscopy in the case of CUP is still controversial. We recommend a bilateral tonsillectomy as a routine procedure for cancer of unknown primary as well as unilateral tonsillar carcinoma. Herewith the detrimental consequences of occult metachronous contralateral tonsillar carcinoma can be prevented.
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Affiliation(s)
- M-N Theodoraki
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Medical Center, Frauensteige 12, 89070 Ulm, Germany
| | - J A Veit
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Medical Center, Frauensteige 12, 89070 Ulm, Germany
| | - T K Hoffmann
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Medical Center, Frauensteige 12, 89070 Ulm, Germany
| | - J Greve
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Medical Center, Frauensteige 12, 89070 Ulm, Germany
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McDonald SA, Qendri V, Berkhof J, de Melker HE, Bogaards JA. Disease burden of human papillomavirus infection in the Netherlands, 1989-2014: the gap between females and males is diminishing. Cancer Causes Control 2017; 28:203-214. [PMID: 28213874 DOI: 10.1007/s10552-017-0870-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 02/08/2017] [Indexed: 01/08/2023]
Abstract
PURPOSE Besides cervical cancer, HPV infection is linked to a multitude of diseases in both males and females, suggesting that vaccination programmes should be re-evaluated, with a judicious assessment made of the disease burden stratified by sex, age, and genotype. Projections of burden into the near future are also needed to provide a benchmark for evaluating the impact of vaccination programmes, and to assess the need for scaling-up preventive measures. METHODS Using the disability-adjusted life-years (DALY) measure, we estimated the total HPV-associated disease burden in the Netherlands. Annual cancer registrations over the period 1989-2014 for all cancers with an aetiological link to HPV infection were retrieved, supplemented by incidence data on high-grade cervical intraepithelial neoplasia (CIN) and anogenital warts. RESULTS Over the recent period 2011-2014, the average annual HPV disease burden was 10,600 DALYs (95% credible interval (CrI):10,260-10,960) in females and 3,346 DALYs (95% CrI: 2,973-3,762) in males. Burden was dominated by cervical cancer, but its share amongst women decreased from 89% in 1989 to 77% in 2014. The male share of the total disease burden increased from 9.8% in 1989 to 26% in 2014. In 2023 (before the expected clinical impact from vaccinating girls), total burden is forecasted at 1.3-fold larger than in 2014. CONCLUSIONS The HPV-associated disease burden is higher than that reported for any other infectious disease in the Netherlands, with a larger burden observed in women than in men. The rapidly rising male share of the total burden underlines the prioritization of male HPV-related disease in prevention programmes.
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Affiliation(s)
- Scott A McDonald
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, PO Box 1, 3720 BA, Bilthoven, The Netherlands.
| | - Venetia Qendri
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, PO Box 1, 3720 BA, Bilthoven, The Netherlands.,VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Johannes Berkhof
- VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Hester E de Melker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, PO Box 1, 3720 BA, Bilthoven, The Netherlands
| | - Johannes A Bogaards
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, PO Box 1, 3720 BA, Bilthoven, The Netherlands
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