Cancer of the oropharynx: classification and natural history

The development, comparative anatomy, and function of the oropharynx are briefly described. The text book descriptions of the anatomical boundaries of the oropharynx are commented on and an attempt is made to define these boundaries more rigidly and accurately. Although the advantages and limitations of the UICC classification of oropharyngeal cancer is accepted, an alternative classification is suggested based on the function of the site involved rather than its descriptive anatomy. This has resulted in a necessary rearrangement of the tumor sites and subsites. Subdivision into three sites is suggested: 1. An anterior or glosso-epiglottic; 2. Lateral or tonsillar; 3. Postero-superior or pharyngoepiglotti. The main change has been in the lateral group, the faucial pillars being separated from the tonsil and reallocated. Three different forms of tonsillar cancer are described in some detail; the linguo (glosso) tonsillar sulcus receives mention. A general account is given of the remaining anterior and posterior sites.