Hi Tami --
He had a tonsillectomy to remove his primary tumor, this was fairly radical (that is, down to connective tissue except ENT did not take anything off the base of tongue where there was some spread of the primary tumor). Negative margins everywhere but there. He also had two lymph nodes involved -- one definite (biopsied), one suspicious due to slight enlargement but not confirmed. (Surgeon said his stage was sort of "3 1/2" but technically IV).
Hopkins generally does not do base-of-tongue surgery, preferring to use chemoradiation with neck dissection later only if scans etc. warrent it. Apparently (per our MO) a number of patients are declining further surgery as there have been some recent papers which show limited additional benefit. Of course Barry will make a final decision when his scans etc. are done in two months but I suspect he will pass on any more surgery unless it is obvious there is still active cancer. The recurrence rate in
HPV+ SCC after treatment is quite low (per Gillison) and this is also an impetus to just closely monitor it.
Gail
