MALIGNANT TUMORS OF THE TONSIL

The various factors affecting the prognosis in 169 patients with malignant tumors of the tonsil have been reviewed. The clinical stage of the primary tumor and the presence of metastatic lymph nodes in the neck are the most important prognostic factors. Age of the patient, sex and histologic classification of the tumor did not affect the prognosis.Patients with small primary tumors or no evidence of metastatic neck lymph nodes exhibited cure rates in the range of 70-80 per cent, in contrast to about 40 per cent for patients with more advanced lesions or clinically palpable lymph nodes. Absence of viable tumor in the tonsil or in the neck lymph nodes of the surgical specimen indicated a good prognosis. However, patients with more than 2 positive lymph nodes in the neck dissection specimen carried a poor prognosis, regardless of the dose of radiation therapy given preoperatively.The mechanisms of failures for the various methods of treatment are reviewed, most of the radiation failures being local and those...