{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T12:25:32Z","timestamp":1788265532033,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T00:00:00Z","timestamp":1625702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe and compare rates of metachronous and synchronous second primaries of the contralateral tonsil in patients with primary HPV(+) tonsillar squamous cell carcinoma (SCC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>This is a single tertiary care center retrospective case series, from 2006 to 2019, of HPV(+) tonsillar SCC patients who underwent primary surgical resection with unilateral wide\u2010field tonsillectomy or bilateral tonsillectomy for diagnostic or therapeutic purposes. A metachronous second primary is one diagnosed &gt;6\u2009months after completion of surgical treatment. A synchronous second primary is one diagnosed during bilateral tonsillectomy for unilateral HPV(+) tonsillar SCC. Rates of second primary and patient characteristics were compared using chi\u2010square tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>About 303 patients underwent unilateral surgical resection +\/\u2212 adjuvant therapy for HPV(+) tonsillar SCC. One (0.3%) developed a metachronous second primary in the contralateral tonsil 11.9\u2009years following treatment. Fifty\u2010seven patients with HPV(+) tonsillar SCC underwent bilateral tonsillectomy, and 37\/57 (65%) had no clinical signs for contralateral disease. Of these, only 1\/37 (2.7%) was incidentally found to have a synchronous second primary. Twenty patients underwent bilateral tonsillectomy due to clinical concern for contralateral disease. Of these, 3\/20 (15%) were found to have a synchronous HPV(+) SCC in the contralateral tonsil.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The prevalence of metachronous second primary after appropriate treatment of HPV(+) tonsillar SCC is very low (0.3%) and so is the chance of incidentally discovering a synchronous second primary during bilateral tonsillectomy (2.7%). We do not recommend bilateral tonsillectomy as a part of the routine algorithm in the surgical management of these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3 <jats:italic>Laryngoscope<\/jats:italic>, 132:332\u2013338, 2022<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29741","type":"journal-article","created":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T11:35:10Z","timestamp":1625744110000},"page":"332-338","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Second Primary Tumors in Patients Presenting With Unilateral <scp>HPV<\/scp>\u2010Associated Tonsillar Squamous Cell Carcinoma"],"prefix":"10.1002","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9414-8206","authenticated-orcid":false,"given":"Ryan A.","family":"McMillan","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Clinic  Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0513-4203","authenticated-orcid":false,"given":"Kathryn M.","family":"Van Abel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Clinic  Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8515-2051","authenticated-orcid":false,"given":"Linda X.","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Clinic  Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2768-003X","authenticated-orcid":false,"given":"David M.","family":"Routman","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Mayo Clinic  Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Mayo Clinic  Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle A.","family":"Neben Wittich","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Mayo Clinic  Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel L.","family":"Price","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Clinic  Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2345-1157","authenticated-orcid":false,"given":"Jan L.","family":"Kasperbauer","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Clinic  Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharine R.","family":"Price","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology Mayo Clinic  Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish V.","family":"Chintakuntlawar","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology Mayo Clinic  Rochester Minnesota U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1103-6212","authenticated-orcid":false,"given":"Eric J.","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Mayo Clinic  Rochester Minnesota 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