{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T17:27:59Z","timestamp":1782926879800,"version":"3.54.5"},"reference-count":16,"publisher":"Wiley","issue":"17","license":[{"start":{"date-parts":[[2017,4,25]],"date-time":"2017-04-25T00:00:00Z","timestamp":1493078400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Concurrent chemoradiation (CCRT) and upfront surgery followed by adjuvant therapy both are recommended treatment options for patients with advanced stage squamous cell carcinoma (SCC) of the tonsil. To the authors' knowledge, the question of whether surgical\u2010based treatments can achieve better survival compared with CCRT has never been compared in a clinical trial. The authors analyzed the National Cancer Data Base to measure the impact of different treatment modalities on overall survival (OS).<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>All patients aged \u226470 years diagnosed with clinical stage III to IVB (excluding T4B) SCC of the tonsil from 1998 through 2011 were selected. Analysis was limited to patients receiving CCRT, surgery plus CCRT, or surgery followed by adjuvant radiotherapy (RT). OS was compared using the Kaplan\u2010Meier method and log\u2010rank test. Univariable and multivariable hazards analyses were performed to identify factors significant for survival. Propensity score matching was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>There were 16,891 patients who met the inclusion criteria. The most common treatment was CCRT (8123 patients; 48.1%), followed by surgery plus CCRT (5249; 31.1%) and surgery plus RT (3519 patients; 20.8%). Patients treated with surgery plus CCRT were found to have the highest 3\u2010year OS rate (88.5%) followed by those treated with surgery plus RT (84%) and CCRT (74.2%) (<jats:italic>P<\/jats:italic>&lt;.0001). In a propensity score\u2010matched subpopulation of 4962 patients, the 3\u2010year OS rate was 90.2% for those treated with surgery plus CCRT, 84.9% for those treated with surgery plus RT, and 82.1% for those treated with definitive CCRT (<jats:italic>P<\/jats:italic>&lt;.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Patients with advanced stage SCC of the tonsil who underwent surgery followed by CCRT had the greatest OS. Patients undergoing upfront surgery may avoid chemotherapy without jeopardizing survival. Triple\u2010modality therapy may provide a survival benefit for a subset of patients with advanced stage tonsil cancer. <jats:bold><jats:italic>Cancer<\/jats:italic> 2017;123:3269\u201076<\/jats:bold>. \u00a9 <jats:italic>2017 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.30728","type":"journal-article","created":{"date-parts":[[2017,4,25]],"date-time":"2017-04-25T15:28:56Z","timestamp":1493134136000},"page":"3269-3276","source":"Crossref","is-referenced-by-count":19,"title":["Triple\u2010modality treatment in patients with advanced stage tonsil cancer"],"prefix":"10.1002","volume":"123","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1476-4573","authenticated-orcid":false,"given":"Dylan F.","family":"Roden","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery New York University New York New York"},{"name":"Department of Veterans Affairs New York Harbor Healthcare New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Schreiber","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs New York Harbor Healthcare New York New York"},{"name":"Department of Radiation Oncology State University of New York Downstate Medical Center Brooklyn New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babak","family":"Givi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery New York University New York New York"},{"name":"Department of Veterans Affairs New York Harbor Healthcare New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,4,25]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"National Comprehensive Cancer Network. Head and Neck Cancers (Version 1.2010).www.nccn.org\/professionals\/physician_gls\/pdf\/head-and-neck.pdf. 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