How do you manage early stage tonsil SCC treated by simple tonsillectomy alone?

Provided that staging PET/CT showed no residual disease or neck involvement, would you recommend completion surgery and neck dissection? Or do you view the tonsillectomy as a biopsy and treat the tonsil and undissected neck with RT to a postop or definitive dose (i.e. 60Gy v. 66-70Gy)?

Answer from: Radiation Oncologist at Community Practice

A simple tonsillectomy is not an oncologically curative surgical procedure. It is analogous to an excision biopsy. Historically, definitive RT was the logical next step for a cN0-1 neck in the setting of an early stage primary & with excellent results (Garden et al from MDACC, & others). A g...

Comments

Radiation Oncologist at University of Michigan
Agree- RT alone to the primary site and ipsilatera...

Radiation Oncologist at University of Texas MD Anderson Cancer Center
Historically, we would irradiate these patients, t...

Radiation Oncologist at UTMB
It appears implicit that RT is reserved for biolog...

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How do you manage early stage tonsil SCC treated by simple tonsillectomy alone?

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