Determining the most effective therapeutic method as a primary treatment for squamous cell carcinoma of the oropharynx

Abstract

Fifty-nine patients with squamous cell carcinoma of the oropharynx, treated between 1978 and 1991 at Aichi Cancer Center, were used for this study. The purpose of this study is to investigate the possibilities and limitations of conservative therapy, as well as surgical problems and the future direction of combined therapy. We divided the patients into two groups receiving primary treatment; those treated conservatively mainly by radiation (42 patients) and those treated mainly by surgery with radical resection (17 patients). We then used several factors to compare the 5-year survival rates between these groups and to evaluate any differences observed. The results were as follows; in T3/T4 grades, ulcerated and invasive tumors and highly differentiated types, the improved prognosis in surgical groups was statistically significant. Whether cervical metastasis was positive or not had no effect on the survival rate of either group. Furthermore, with lateral wall type, both groups had good prognoses. These data suggest that therapy should not be selected on the basis of stage or positive cervical metastasis, but by T factor, location, tumor type (expansive or invasive) and histologic differentiation. At present, we consider these factors to be key elements influencing the possibilities and limitations of conservative therapy for oropharyngeal squamous cell carcinoma.