Unilateral transoral surgery for tonsillar squamous cell carcinoma shows similar survival rates and low contralateral tumor risk compared to bilateral procedures, based on a meta-analysis of 1,486 patients. The study revealed a 0.1% incidence of contralateral tumors in unilateral procedures versus 4% in bilateral cases, with two-year and five-year overall survival rates at 96% and 84% respectively for unilateral surgeries. Complication rates, including oropharyngeal hemorrhage and dependence on feeding tubes, were not significantly different. The findings support a selective surgical approach, especially for HPV-positive patients, although the study acknowledged limitations in data completeness and retrospective design. This research was presented by Dr. Andrew M. Peterson from Washington University School of Medicine.
1. Unilateral surgery shows a 0.1% risk of contralateral tumors. 2. Five-year survival rates: unilateral 84%, bilateral 78%. 3. HPV positivity in 92.6% of patients. 4. Oropharyngeal hemorrhage: 6% for both procedures. 5. No significant difference in swallowing outcomes between groups. 6. The study was retrospective, which introduces potential bias. 7. Unilateral surgery does not compromise outcomes for HPV-positive patients. 8. Decision-making should be patient-specific within a multidisciplinary context.
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