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Comparing tonsillectomy versus tonsil biopsy in the diagnosis of palatine tonsil squamous cell carcinoma – a retrospective analysis of subsequent resection margins

Published online by Cambridge University Press:  08 April 2025

Christopher Heining*
Affiliation:
ENT, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
Oliver Dale
Affiliation:
University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
James Constable
Affiliation:
Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
*
Corresponding author: Christopher Heining; Email: chrisheining@hotmail.co.uk

Abstract

Objectives

Palatine tonsil squamous cell carcinoma can be diagnosed with either tonsillectomy or tonsil biopsies. Biopsies are quicker to perform, less invasive, and provide potentially quicker results. Tonsillectomy minimises risk of missed pathology, but with greater associated morbidity. We compared whether tonsillectomy or biopsy affected surgical margin status at subsequent resection.

Methods

Our Business Intelligence Team provided a list of all patients with a primary tonsil squamous cell carcinoma who underwent surgery as their primary treatment modality in the last five years at University Hospitals Bristol. Demographic and treatment details were collected along with margin status following surgical resection.

Results

Of the 31 patients that met inclusion criteria, 16 had biopsies and 15 had diagnostic tonsillectomies. The group who underwent tonsillectomy had a reduced risk of close or involved margins (< 5 mm) at subsequent curative-intent surgery (p < 0.001).

Conclusions

Our results suggest that tonsillectomy is associated with reduced likelihood of close or involved margins at subsequent curative-intent surgery. We hope this work can prompt larger multicentre comparisons between these two groups to investigate this relationship in more detail.

Information

Type
Main Article
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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Footnotes

Previously presented as a poster at South West ENT Academic Meeting September 2023 Royal United Hospitals Bath UK

Christopher Heining takes responsibility for the integrity of the content of the paper

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