{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T16:32:15Z","timestamp":1770741135424,"version":"3.49.0"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,3,7]],"date-time":"2017-03-07T00:00:00Z","timestamp":1488844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Compare survival outcomes between unimodality and multimodality treatments for early\u2010stage tonsil squamous cell carcinoma (SCC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design and Setting<\/jats:title><jats:p>Review of the National Cancer Database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Patients were selected if they were &lt;70 years old with clinical stage I\u2010II SCC of the tonsil, as documented in the National Cancer Database from 1998 to 2011. Palliative and nonstandard treatments were excluded. Propensity score matching was performed, controlling for tumor stage, age, race, comorbidity, insurance status, and year of diagnosis. Overall survival (OS) was compared with the Kaplan\u2010Meier method and log\u2010rank test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 3247 patients. Radiotherapy (RT) was delivered in 1295 patients (39.9%), surgery in 824 (25.4%), and surgery + RT in 1128 (34.7%). Patients treated with surgery + RT had the highest 5\u2010year OS (81.1%), followed by surgery (67.4%) and RT (63.4%; <jats:italic>P<\/jats:italic> &lt;. 001). In a propensity score\u2013matched subpopulation of 2378 patients, the 5\u2010year OS was 78.8% for surgery + RT, 66.7% for surgery, and 64.5% for RT (<jats:italic>P<\/jats:italic> &lt;. 001). Among patients who underwent surgical tonsillectomy plus elective neck dissection and\/or adjuvant RT, the 5\u2010year OS was equal (<jats:italic>P<\/jats:italic> =. 29), and all were superior to RT alone (<jats:italic>P<\/jats:italic> &lt;. 001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Multimodality treatment is associated with the greatest survival in early\u2010stage tonsil cancer. The addition of tonsillectomy to RT confers a 20% increase in survival. The current guidelines might not offer the most effective treatment. An up\u2010front surgical approach, followed by appropriately selected adjuvant therapy, may result in improved survival for early\u2010stage tonsil SCC. These findings merit investigation in a prospective clinical trial.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599817696290","type":"journal-article","created":{"date-parts":[[2017,3,7]],"date-time":"2017-03-07T08:01:11Z","timestamp":1488873671000},"page":"62-68","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Multimodality Treatment of Early\u2010Stage Tonsil Cancer"],"prefix":"10.1002","volume":"157","author":[{"given":"Dylan F.","family":"Roden","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery New York University New York NY USA"},{"name":"Department of Veterans Affairs New York Harbor Campus Brooklyn New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Schreiber","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs New York Harbor Campus Brooklyn New York USA"},{"name":"Department of Radiation Oncology State University of New York Downstate Medical Center Brooklyn New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Babak","family":"Givi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery New York University New York NY USA"},{"name":"Department of Veterans Affairs New York Harbor Campus Brooklyn New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,3,7]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"NCCN Guidelines: Version 1.2016. Head and Neck Cancers","author":"Pfister D","year":"2016"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29938"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23995"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24712"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2013.107"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.2217\/cer.14.26"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-014-2939-0"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21021"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/421964"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200311000-00018"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0912217"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.212"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-13-133"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599817696290","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599817696290","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599817696290","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T13:46:11Z","timestamp":1760967971000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599817696290"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3,7]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017,7]]}},"alternative-id":["10.1177\/0194599817696290"],"URL":"https:\/\/doi.org\/10.1177\/0194599817696290","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3,7]]},"assertion":[{"value":"2016-11-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-01-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-03-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}