Exploring tonsillar cancer associations in patients with base of tongue cancer - insights from a single-center study

Sep 21, 2026

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Purpose explores the prevalence of synchronous and metachronous tonsillar cancer in patients diagnosed with base of tongue cancer and identifies potential risk factors for these secondary malignancies. The study asks whether bilateral tonsillectomy should be recommended for base of tongue cancer patients. Methods: case-series at Aarhus University Hospital with histologically confirmed cases from 2012–2021, analyzing electronic records and applying Fisher’s exact test. Results and conclusion assess low overall prevalence and implications for routine tonsillectomy decisions.

LanguageEnglish

CategoryResearch & Report

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Pages5

Reading Time13 min

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European Archives of Oto-Rhino-Laryngology (2024) 281:5955–5959 [https://doi.org/10.1007/s00405-024-08830-7](https://doi.org/10.1007/s00405-024-08830-7) HEAD AND NECK Exploring tonsillar cancer associations in patients with base of tongue cancer: insights from a single-center study Sebastian Udholm1 · Nina B. Sannino-Greve1 · Tejs Ehlers Klug1 Received: 2 May 2024 / Accepted: 3 July 2024 / Published online: 23 July 2024 © The Author(s) 2024 Abstract Purpose To explore the prevalence of synchronous and metachronous tonsillar cancer in patients with base of tongue cancer, as well as identifying potential risk factors linked to these secondary malignancies. We aim to answer the following question: Should bilateral tonsillectomy be recommended to patients diagnosed with base of tongue cancer? Methods A case-series study was conducted at Aarhus University Hospital, including all patients with histologically confirmed base of tongue squamous cell carcinoma treated between January 2012 and December 2021. Data from electronic patient records, including diagnosis of prior, synchronous or metachronous tonsillar cancer, demographics, and clinical features were analysed. Fisher’s exact test was performed to assess factors associated with synchronous and metachronous tonsillar cancer. Results Among 198 patients with base of tongue cancer, 5.6% had a history of tonsillar cancer, either prior to (4.5%), synchronous (0.5%), or metachronous (0.5%) to the base of tongue diagnosis. The prevalence of synchronous or metachronous tonsillar cancer among patients without previous bilateral tonsillectomy was 1.2% . Patients with tonsillar cancer were older, had heavier smoking histories, and exhibited less frequent P16-overexpression. Conclusion Our findings deepen understanding of tonsillar cancer in patients with base of tongue cancer. The prevalence of synchronous or metachronous tonsillar cancer was found to be relatively low, suggesting that routine tonsillectomy for all base of tongue cancer patients is not warranted. Keywords Base of tongue · Head and neck cancer · Carcinoma · Malignancy · Secondary cancer · Cancer Introduction The risk of developing a second primary malignancy is increased in patients with head and neck cancer [1, 2] . These malignancies may manifest either synchronous (diagnosed either at the same time as the primary lesion or within six months) or metachronous (more than six months after the primary cancer) . Occurrence of secondary primary malignancies constitute major clinical issues as they impact patients prognosis negatively; indeed, these malignancies are one of the leading causes of death in patients with head and neck cancer [3]. In newly diagnosed head and neck cancer patients, the occurrence of synchronous malignancies 􀀍 Sebastian Udholm [udholm@clin.au.dk](udholm@clin.au.dk) 1 Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus N. University Hospital, Aarhus DK-8200, Denmark is estimated to be in the range 1–6%, while metachronous malignancies occur in almost one third of patients [4–7] . As such, it has long been recognised that individuals with head and neck squamous cell carcinoma face an increased susceptibility to developing second primary malignancies. Only few studies have, however, investigated the locationsand specific risks associated with synchronous and metachronous second primary malignancies across the spectrum of head and neck subsites, including patients with base of tongue cancer [8–10] . Although base of tongue cancer, a subset of oropharyngeal malignancies, is garnering increasing attention due to its rising incidence and complex clinical nature, the prevalence and characteristics of synchronous and metachronous tonsillar cancer in these patients remain unexplored [11] . It is important to identify the risk profile linked to these secondary malignancies in patients with base of tongue cancer to enhance patient counselling, improve management, and

FAQs

What was the main purpose of the study?

To determine how common synchronous and metachronous tonsillar cancer is among patients with base of tongue cancer and to identify possible risk factors for these secondary malignancies.

How were patients and data collected for the analysis?

The study included all histologically confirmed base of tongue squamous cell carcinoma patients treated at Aarhus University Hospital from January 2012 to December 2021, using electronic patient records.

What did the study find about the prevalence of tonsillar cancer in this patient group?

Among 198 base of tongue cancer patients, 5.6% had a history of tonsillar cancer, and synchronous or metachronous tonsillar cancer prevalence was 1.2% in patients without previous bilateral tonsillectomy.

Sep 21, 2026

Uploaded by Skyler