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, L'objectif de notre étude était d'évaluer l'impact d'une amygdalectomie uni ou bilatérale sur la découverte de la tumeur primitive et la survie de patients présentant des adénopathies prévalentes cervicales de carcinome épidermoïde

M. Matériel,

, Il s'agissait d'une étude rétrospective portant sur 63 patients, inclus de janvier 2008 à décembre 2017 dans le centre hospitalo universitaire de Marseille. Tous les patients inclus avaient eu un bilan initial exhaustif par examen clinique, TDM cervico-thoracique

, La recherche de la présence d'EBV et d'HPV a pu être réalisée chez 43/63 patients (68%)

, Les deux analyses ont été effectuées lors de la prise en charge initiale ou rétrospectivement après avoir obtenu le consentement écrit des patients

, Les analyses statistiques ont été effectuées avec le logiciel IBM SPSS Statistics, vol.20, p.0

, Résultats : Parmi les 63 patients initiaux 47 ont bénéficié d'une amygdalectomie uni ou bilatérale

, Le primitif amygdalien était ipsilatéral au ganglion dans 10 cas (83%)

, cas (8%) et indeterminé (car présence d'adénopathies bilatérales) dans 1 cas (8%)

, 5%) ont eu une complication hémorragique post amygdalectomie

, Les cancers de l'amygdale retrouvés étaient statistiquement plus p16+ que les ADPpCCE

, Les patients p16+ présentaient statistiquement plus d'adénopathies localisées dans le secteur II (p=0,046)

, La survie globale et sans récidive était significativement meilleure chez les patients pour lesquels on avait trouvé un primitif amygdalien respectivement p= 0,027 et p=0,008 (survie globale à 5 ans : 72,6% pour le groupe avec une amygdalectomie versus 48,5% pour les patients sans ce geste

, Au vu de la forte association de la p16+ avec la découverte d'un cancer amygdalien chez les

. Adppcce, nous proposons d'intensifier la prise en charge diagnostique des ADPpCCE p16+ en réalisant chez ces patients une amygdalectomie bilatérale systématique. L'exérèse du tissu lymphoïde basi-lingual peut se discuter en cas d'amygdalectomie négative