{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:01:27Z","timestamp":1791936087504,"version":"4.3.4"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,11,21]],"date-time":"2017-11-21T00:00:00Z","timestamp":1511222400000},"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":[[2018,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study introduces a treatment algorithm based on staging neck dissection to identify patients with palatine tonsil squamous cell carcinoma who can be effectively treated with single\u2010modality transoral robotic surgery while maintaining quality of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Kaiser Permanente Southern California Medical Group from 2012 to 2017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Patients with early\u2010stage (T1\/2) palatine tonsil squamous cell carcinoma with clinically and radiographically N0\u00a0necks underwent staging neck dissection. Those with pN2\/3 disease or extracapsular extension on final pathology were triaged to definitive chemoradiation treatment. Patients with confirmed pN0\/1\u00a0necks without extracapsular extension were treated definitively with transoral robotic surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nineteen patients with cN0 disease underwent selective neck dissection. All were p16 positive. Of these, 14 had pathologically confirmed N0\/1\u00a0necks without extracapsular extension and were treated with primary surgical resection via transoral robotic surgery. Clear margins were obtained on all patients. There were no significant intra\u2010 or postoperative complications. No patients required gastrostomy tube or tracheostomy placement. Mean and median follow\u2010up was 28\u00a0months with no recurrences to date.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Up\u2010front staging neck dissection accurately triages low\u2010risk patients, determining candidates for single\u2010modality definitive treatment with transoral robotic surgery. This approach provides excellent survival outcomes and minimal morbidity and maintains quality of life among appropriately selected patients with palatine tonsil cancer.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599817742615","type":"journal-article","created":{"date-parts":[[2017,11,21]],"date-time":"2017-11-21T08:01:52Z","timestamp":1511251312000},"page":"479-483","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Staging Neck Dissection and Transoral Robotic Surgery Treatment Algorithm in Palatine Tonsil Cancer"],"prefix":"10.1002","volume":"158","author":[{"given":"Joseph","family":"Spellman","sequence":"first","affiliation":[{"name":"Department Otolaryngology\u2013Head and Neck Surgery Naval Medical Center San Diego San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Sload","sequence":"additional","affiliation":[{"name":"Department Otolaryngology\u2013Head and Neck Surgery Naval Medical Center San Diego San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery Kaiser Permanente Southern California Medical Group Fontana California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery Kaiser Permanente Southern California Medical Group San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Calzada","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery Kaiser Permanente Southern California Medical Group San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLG.0000170848.76045.47"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000088012"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000199899.00479.75"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2010.191"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24712"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032646"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032641"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20279"},{"key":"e_1_2_8_10_1","unstructured":"National Comprehensive Cancer Network.NCCN clinical practice guidelines in oncology: head and neck cancers v2.2017.https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/head\u2010and\u2010neck.pdf. 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