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Purpose The incidence of human papillomavirus (HPV)-related oropharyngeal cancer (OPC) has increased, and staging and optimal therapeutic approaches are challenging. A questionnaire survey was conducted to investigate the controversial treatment policy of stage T2 OPC according to the N category and determine the opinions of multidisciplinary experts in Korea. Materials and Methods Five OPC scenarios were developed by the Subcommittee on Oropharyngeal Treatment Guidelines of the Korean Society for Head and Neck Oncology and distributed to experts of multidisciplinary treatment hospitals. Results Sixty-five experts from 45 institutions responded. For the HPV-positive T2N0M0 scenario, 67.7% of respondents selected surgery followed by definitive concurrent chemoradiotherapy (CCRT) or radiotherapy alone. For the T2N1M0 HPV-positive scenario, there was a notable difference in the selection of primary treatment by expert specialty; 53.9% of respondents selected surgery and 39.8% selected definitive CCRT as the primary treatment. For the T2N3M0 advanced HPV-positive scenario, 50.0% of respondents selected CCRT and 33.3% considered induction chemotherapy (IC) as the primary treatment. CCRT and IC were significantly more frequently selected for the HPV-related OPC cases (p=0.010). The interdepartmental variability showed that the head and neck surgeons and medical oncologists favored surgery, whereas the radiation oncologists preferably selected definitive CCRT (p < 0.001). Conclusion In this study, surgery was preferred for lymph node-negative OPC, and as lymph node metastasis progressed, CCRT tended to be preferred, and IC was administered. Clinical practice patterns by stage and HPV status showed differences according to expert specialty. Multidisciplinary consensus guidelines will be essential in the future. [ABSTRACT FROM AUTHOR]

Objective: To determine whether invasion of the pharyngeal constrictor muscle in early squamous cell carcinoma of the tonsil is correlated with lymph node metastasis. Design: Retrospective analysis of medical records and pathology specimens. Setting: Tertiary care referral center. Patients: Forty-eight patients who were diagnosed as having T2 squamous cell carcinoma of the tonsil and who underwent surgery. They were divided into 2 groups: an invasive group with invasion of the pharyngeal constrictor muscle and a noninvasive group without invasion of the pharyngeal constrictor muscle. Main Outcome Measures: Comparison of regional metastasis, 5-year locoregional recurrence, and 5-year disease- specific survival between the 2 groups. Results: Invasion of the pharyngeal constrictor muscle was found in 36 patients (75%) with T2 squamous cell carcinoma of the tonsil. The rate of lymph node metastasis, the mean (SD) number of positive nodes, and the mean (SD) lymph node density were 81%, 5.47 (9.27), and 0.15 (0.22) in the invasive group, respectively, and 50%, 1.33 (1.72), and 0.04 (0.04) in the noninvasive group, respectively (P=.04, P=.02, and P=.01, respectively). Five-year locoregional recurrence was significantly correlated with invasion of the pharyngeal constrictor muscle (P=.05) and with multiple lymph node metastasis (⩾5 nodes) (P=.04) in the univariate analyses. No factor was correlated with 5-year locoregional recurrence in the multivariate analysis. Five-year diseasespecific survival was significantly correlated with multiple lymph node metastasis (⩾5 nodes) in the univariate analyses (P=.009). Five-year disease-specific survival was not significantly correlated with any clinicopathological factor in the multivariate analysis. Conclusion: Higher risk for multiple lymph node metastasis and 5-year locoregional recurrence seems to be predicted in patients with extratonsillar invasion of the pharyngeal constrictor muscle, even in early squamous cell carcinoma of the tonsil. [ABSTRACT FROM AUTHOR]

The task of the present study was to investigate the relationship between parameters and factors predictive of voice quality and to suggest treatment guidelines for patients suffering from vocal polyps. In total, 158 patients diagnosed with vocal polyps and who received voice therapy were enrolled. Clinicomorphological factors such as size, location, color, and type of the polyp were evaluated. Perceptive and acoustic voice evaluation was conducted and the relationship of these voice parameters with clinicomorphological factors was analyzed. Additionally, factors favorable for voice therapy were investigated. GRBAS scale grade was closely related to acoustic parameters, such as jitter and shimmer. Univariate analysis showed the size of the polyp, the color of the vocal fold, a history of voice abuse, associated muscle tension dysphonia (MTD), and opposing reactive scar affected voice quality. In multivariate analysis, only the size of the polyp was associated with voice quality. The patients in whom the voice quality improved with voice therapy initially had smaller polyps and whitish-colored vocal folds. Results of the present study indicate that although the most influential factor on voice quality in vocal polyp patients was the size, several other factors should be considered in evaluating and treating vocal polyps. The size of the polyp and the color of the vocal fold are indicative of success or failure in voice therapy. [ABSTRACT FROM AUTHOR]