Surgical management of T1 oropharyngeal carcinoma.

Abstract

The purpose of this study was to assess the efficacy of primary transoral surgery in the management of T1 oropharyngeal carcinoma. A retrospective evaluation was conducted on the files of all patients treated with primary surgery for pT1 oropharyngeal carcinoma at a tertiary referral center between 1976 and 2005. A total of 223 cases were assessed. Disease-specific survival was 88% and local control 93%. Transoral surgery with the use of CO(2) laser or electrocautery was adopted in every case. Positive surgical margins and regional disease were found to significantly worsen prognosis. A low rate of complications and satisfactory retention of pharyngeal function were noted. Primary transoral surgical treatment is very effective against T1 oropharyngeal carcinoma. A low rate of complications should be expected. However, in every case complete excision of the tumor must be accomplished and the neck included in the primary treatment plan.