Tonsil and tongue base SCC. A 10 year regional review.

M Bergin. R Allison.

The incidence of tonsil and tongue base squamous cell carcinoma (SCC) is increasing internationally and the Human Papilloma Virus (HPV) is thought to be responsible for this trend. We reviewed local data from our regional Head and Neck service in Christchurch to identify tumour characteristics and changing patterns over a ten year period from 2006 to 2015. There were 69 tongue base tumours and 91 tonsil tumours identified from a search of medical records and our local Head and Neck clinic database. The incidence of tonsil and tongue base tumours nearly trebled from 1.5 per 100,000 to 4.3 per 100,000 over this time. 64% presented with either T1 or T2 stage disease, and 84% had nodal disease at presentation. HPV data was only available for the final three years of analysis and showed an overall prevalence of over 84%. Nearly 79% of all tumours were treated with primary radiotherapy or chemoradiotherapy. While our local preference is currently to treat tonsil and tongue base SCC with (chemo)radiotherapy, scope exists with early T stage lesions for a primarily surgical approach. It is hoped that immunisation against HPV will lead to fewer oropharyngeal cancers and it is timely that immunisation be extended to young males in New Zealand to decrease HPV prevalence in the community.