Role of palatine tonsillectomy in the diagnostic workup of head and neck squamous cell carcinoma of unknown primary origin: A systematic review and meta-analysis

Pasquale Di Maio, Oreste Iocca, Armando De Virgilio, Fabio Ferreli, Giovanni Cristalli, Raul Pellini, Pawel Golusinski, Giampietro Ricci, Giuseppe Spriano

Research output: Contribution to journalArticle

Abstract

Background: This systematic review and meta-analysis aims to evaluate the effectiveness of palatine tonsillectomy in patients with cervical metastasis from squamous cell carcinoma of unknown primary (SCCUP) origin. Methods: A systematic review including studies that encompassed palatine tonsillectomy in the SSCUP diagnostic evaluation was conducted. A single arm meta-analysis was then made to obtain the overall identification rate of tonsillectomy. Results: Fourteen studies were included, comprising 673 patients who underwent 416 palatine tonsillectomies, 338 preformed during examination under anesthesia (EUA) and 78 managed with transoral robotic surgery (TORS). A total of 140 occult tonsillar malignancies were identified; of these, 124 (89%) were ipsilateral, 2 (1%) contralateral, and 14 (10%) synchronous bilateral. Meta-analysis of 11 studies showed an overall detection rate of tonsillectomy of 0.34 (99% confidence interval 0.23-0.46). Conclusion: Palatine tonsillectomy is a valuable diagnostic tool in the management of patients with head and neck SCCUP. Bilaterality of tonsillectomy should be taken into consideration.

Original languageEnglish
JournalHead and Neck
DOIs
Publication statusAccepted/In press - Jan 1 2018

Keywords

  • cervical lymph node metastases
  • palatine tonsillectomy
  • panendoscopy
  • squamous cell carcinoma
  • unknown primary

ASJC Scopus subject areas

  • Otorhinolaryngology

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