The Impact of Tonsillectomy on Oropharyngeal Cancer Development

Decreasing numbers of tonsillectomies (TE) and an increasing frequency of oropharyngeal squamous cell carcinoma (OPSCC) is a well-known finding in western societies. A retrospective cohort study was performed to investigate the association between a history of TE and the development of OPSCC.

This study included all OPSCC patients who were treated between 2004 and 2023 at the Department of Otorhinolaryngology in University Medical Centre Ruppin Brandenburg in Germany. Digital patient charts were used to collect patient information.

Of the 320 patients with OPSCC, 19 (5.9%) had a history of TE. In 63.2% of cases, the procedure was performed in childhood, and 36.8% in adulthood. Our results indicate significant differences in terms of tumor location between the patients with and without a history of TE (p=0.010). In patients without TE, OPSCC was localized in the tonsillar region (45%), in the base of the tongue (29%), and other regions (26%). In patients with a history of TE the frequency was 16%, 63%, and 21%, respectively. Age at initial diagnosis, initial tumor size, p16/HPV status, residual tumor, venous and lymphatic extracapsular extension, recurrence, and alcohol abuse significantly influenced overall survival without any difference between the two groups.

A history of TE is associated with a decreased risk of tumor localization in the tonsillar region, especially when TE was performed in adulthood. Additionally, in patients with OPSCC and a history of TE, the tumor is more frequently localized at the base of the tongue. A history of TE does not affect demographics, the outcomes of tumor parameters or the prognosis of our patients.