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Galloway TJ , Lango MN , Burtness B , Mehra R , Ruth K , Ridge JA
Unilateral neck therapy in the human papillomavirus ERA: accepted regional spread patterns
Head Neck. 2013 Feb;35(2) :160-4
PMID: 22302641    PMCID: PMC 4037756   
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BACKGROUND: The purpose of this study was to determine whether the incidence of bilateral neck disease tonsillar cancer is rising. METHODS: We reviewed tonsillar cancer incidence data from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute. RESULTS: The annual incidence of advanced neck disease (>/=N2) with small primary tonsillar cancer is increasing (annual percent change [APC]; p < .05) during 2 evaluable time frames (1988-2003 and 2004-2008). The increase for small primary tonsillar cancer from 2004 to 2008 is associated with increased ipsilateral disease (ie, T1-2N2a-b, APC 10.6%; p < .05) rather than bilateral neck disease (T1-2N2c, APC 5.9%, APC = NS). The increase in bilateral neck disease is less than the overall rise in T1 to 2 tonsillar cancer (APC 7.2%; p < .05). CONCLUSION: In the human papillomavirus (HPV) era, bilateral neck disease is increasingly common. This seems to be a consequence of the increasing incidence of tonsillar cancer rather than a new biologic behavior.
Galloway, Thomas J Lango, Miriam N Burtness, Barbara Mehra, Ranee Ruth, Karen Ridge, John A United States Head & neck Head Neck. 2013 Feb;35(2):160-4. doi: 10.1002/hed.22929. Epub 2012 Feb 2.