Prophylactic contralateral neck dissection has no advantage in patients with early stage HPV-positive tonsil cancer

Background: Patients with locally advanced HPV-positive tonsil cancer would benefit from prophylactic contralateral neck dissection (pCND). Aims/Objectives: The aim of this study was to analyze rates of contralateral lymph node metastases (LNM) and their prognostic effects on locally advanced HPV-positive tonsillar squamous cell carcinoma. Materials and methods: Medical records of 54 patients who underwent upfront primary surgery and pCND were retrospectively reviewed. Results: Six (11.1%) patients had contralateral LNM in 54 locally advanced HPV-positive tonsil cancer. Of these, five patients had contralateral level II LNM and one patient had contralateral level II and III LNM. Contralateral LNM showed significant positive correlations with advanced T stage (p = .017) and the presence of extracapsular spread (p = .007). Contralateral lymph node metastasis had no significant association with five-year disease-specific survival. Conclusions and significance: This study demonstrated no advantage in performing pCND in early stage HPV-positive tonsil cancer.