{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T08:20:21Z","timestamp":1791534021227,"version":"4.3.4"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,12,8]],"date-time":"2020-12-08T00:00:00Z","timestamp":1607385600000},"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":[[2021,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the patterns of care and outcomes of treatment of early stage tonsil cancers, controlling for human papillomavirus (HPV) status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Historical cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>National Cancer Database (NCDB).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Review of the NCDB between 2010 and 2017 for all T1\u20102N0M0 tonsillar squamous cell carcinoma (SCC). Demographics, clinical characteristics, HPV status, treatment regimens, and survival were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 4720 patients were identified with early stage SCC of the tonsil. Most were tested for HPV (2759 [58.5%]). Among tested patients, 1758 (63.7%) were positive for HPV and 1001 (36.3%) were negative for HPV. HPV\u2010positive patients had higher 3\u2010year survival compared to HPV\u2010negative patients (93.2% vs 77.8%, <jats:italic>P<\/jats:italic> &lt;. 001). Among HPV\u2010positive patients, there was no significant difference in survival between treatment cohorts. However, in the HPV\u2010negative cohort, 3\u2010year survival was higher in both bimodality surgical\u2010based settings (tonsillectomy + neck dissection + radiotherapy, 86.0% vs chemoradiotherapy, 69.6%, <jats:italic>P<\/jats:italic> =. 01) and for all surgical\u2010based treatments when compared to nonsurgical management (84.6% vs 69.3%, <jats:italic>P<\/jats:italic> &lt;. 001). This difference was maintained in multivariable regression controlling for age, sex, comorbidities, clinical T stage, and treatments. In a subpopulation of HPV\u2010negative patients propensity score matched by all factors significant in multivariable analysis, 3\u2010year survival remained higher in the surgically treated group compared to the nonsurgically treated cohort (84.9% vs 67.1%, <jats:italic>P<\/jats:italic> &lt;. 001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Surgical\u2010 or radiation\u2010based treatment resulted in similar survival in early stage HPV\u2010positive tonsil cancer. Surgical\u2010based treatments were associated with longer survival in HPV\u2010negative cancers. These findings should be further investigated in a randomized prospective trial.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599820973256","type":"journal-article","created":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T13:19:05Z","timestamp":1607606345000},"page":"104-112","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Treatment of Early Stage Tonsil Cancer in the Age of Human Papillomavirus\u2013Associated Malignancies"],"prefix":"10.1002","volume":"165","author":[{"given":"Evan J.","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery NYU School of Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela W.","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery NYU School of Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie R.","family":"Oliver","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery NYU School of Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MacIntosh","family":"Cornwell","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery NYU School of Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam S.","family":"Jacobson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery NYU School of Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth S.","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology NYU School of Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses","family":"Tam","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology NYU School of Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alec","family":"Vaezi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery NYU School of Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc G. T.","family":"Morris","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery Memorial Sloan Kettering Cancer Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babak","family":"Givi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery NYU School of Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.2011.0298"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.14.1713"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semradonc.2011.12.004"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0912217"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.10960"},{"key":"e_1_2_9_7_1","unstructured":"National Comprehensive Cancer Network.NCCN clinical practice guidelines for oncology: head and neck cancers. 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