Palatine tonsil squamous cell carcinoma can be diagnosed with either tonsillectomy or tonsil biopsies. Biopsies are quicker to perform, less invasive, and provide potentially quicker results. Tonsillectomy minimises risk of missed pathology, but with greater associated morbidity. We compared whether tonsillectomy or biopsy affected surgical margin status at subsequent resection.

Our Business Intelligence Team provided a list of all patients with a primary tonsil squamous cell carcinoma who underwent surgery as their primary treatment modality in the last five years at University Hospitals Bristol. Demographic and treatment details were collected along with margin status following surgical resection.

Of the 31 patients that met inclusion criteria, 16 had biopsies and 15 had diagnostic tonsillectomies. The group who underwent tonsillectomy had a reduced risk of close or involved margins (< 5 mm) at subsequent curative-intent surgery (p < 0.001).

Our results suggest that tonsillectomy is associated with reduced likelihood of close or involved margins at subsequent curative-intent surgery. We hope this work can prompt larger multicentre comparisons between these two groups to investigate this relationship in more detail.