TY - JOUR
T1 - Role of palatine tonsillectomy in the diagnostic workup of head and neck squamous cell carcinoma of unknown primary origin
T2 - A systematic review and meta-analysis
AU - Di Maio, Pasquale
AU - Iocca, Oreste
AU - De Virgilio, Armando
AU - Ferreli, Fabio
AU - Cristalli, Giovanni
AU - Pellini, Raul
AU - Golusinski, Pawel
AU - Ricci, Giampietro
AU - Spriano, Giuseppe
PY - 2018/1/1
Y1 - 2018/1/1
N2 - 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.
AB - 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.
KW - cervical lymph node metastases
KW - palatine tonsillectomy
KW - panendoscopy
KW - squamous cell carcinoma
KW - unknown primary
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U2 - 10.1002/hed.25522
DO - 10.1002/hed.25522
M3 - Article
AN - SCOPUS:85058979989
JO - Head and Neck Surgery
JF - Head and Neck Surgery
SN - 1043-3074
ER -