TABLE IV.
Patterns of Failure and Secondary Primaries.
| Patient | Primary Site | T Stage | N Stage | ECS | HPV Positive | Positive Margins | Neck Dissections | High Risk* | Adjuvant Therapy | Site of Recurrence | Time to Recurrence (mo) | Second Primary Site | Time to Second Primary (mo) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Tonsil | 2 | 2 | Y | Y | N | Ips | Y | RT | D | 16 | ||
| 2 | BOT | 2 | 2 | Y | ? | Y | Ips | Y | RT | R, D | 62 | Cont. tonsil | 43 |
| 3 | Tonsil | 3 | 1 | N | N | N | Ips | N | RT, C | L, R, D | 11 | ||
| 4 | BOT | 3 | 3 | Y | ? | Y | Bil | N† | none | D | 1 | ||
| 5 | BOT | 2 | 2 | Y | Y | N | Bil | Y | RT, C | R, D | 5 | ||
| 6 | BOT | 3 | 2 | Y | Y | N | Bil | Y | RT, C | R | 24 | ||
| 7 | Tonsil | 1 | 2 | Y | Y | N | Ips | Y | RT | RMT | 53 |
*
High risk refers to patients with two or more positive nodes, presence of ECS, or positive margins. The critical role of TLM as apposed to the adjuvant therapy is emphasized by significance of negative margins on survival (H.R. = 4.78).
†
Patient not included in high-risk analysis due to death prior to adjuvant therapy initiation.
T stage = tumor stage; N stage = nodal stage; ECS = extracapsular spread; HPV = human papilloma virus; Y = yes; N = no; Ips = ipsilateral; RT = radiotherapy; D = distant; BOT = base of tongue; R = regional; cont. = contralateral; C = chemotherapy; L = local; ? = unknown; Bil = bilateral; RMT = retromolar trigone; mo = months.