This study identifies significant prognostic factors in squamous cell carcinomas of the anterior tongue and floor of mouth. It is clear that the TMN staging system does not account for other important variables that affect tumor prognosis. Tumor thickness and the presence of perineural invasion and intralymphatic tumor emboli should be examined in all resected tumors. Tumor thickness, tumor size, and perineural invasion all have an impact on survival and must be considered in treatment plans. Tumors measuring between 2 mm and 3 mm may or may not have metastases and further evaluation of this group needs to be done. Most importantly, the data in this study supports a multiinstitutional prospective evaluation of pathology specimens. Precise guidelines must be established for handling of the specimen, which must then be evaluated for the variables mentioned above. In this way, more definitive conclusions can be reached in the management of tumors of the anterior tongue and floor of mouth.

No abstract

Introduction It is the opinion of many surgeons that the biologic potential of cancer that develops in young people is different compared with older patients. Prior reports on small series of patients addressing this issue have inadequate statistical power to resolve the question. Methods By use of the techniques of meta‐analysis, patients less than 40 years old who had undergone treatment of squamous cell carcinoma (SCC) of the oral tongue were examined. Twenty‐eight patients who were encountered in the Department of Otolaryngology, University of Pittsburgh School of Medicine, and 94 patients were identified in the literature for a total of 122 patients <40 years old. A control group of 150 patients, aged 40 years and older treated for SCC of the oral tongue between 1982 and 1994 was identified. Results Three‐year disease‐free survival in the group of patients aged less than 40 was 53.3% compared with 3‐year disease free survivorship of 55.0% in the older cohort of patients. Conclusion These data strongly suggest that the outcomes of treatment for SCC of the oral tongue in young patients are similar compared with patients older than 40 with similar extent of disease. © 2000 John Wiley & Sons, Inc. Head Neck 22: 297–302, 2000.

A retrospective review of 202 patients with supraglottic squamous cell carcinoma and at least 2 years of follow-up was performed. Surgery alone was used to treat 102 patients, and combined therapy in 100 patients. Local-regional failure occurred in 47 (23%) patients. Only 4 patients (2%) developed recurrence at the primary site. The neck was the most common site for recurrent disease (39/47 or 83%), which in 35 patients appeared in the undirected, contralateral side. The risk to the contralateral side of the neck in patients with midline (epiglottic) lesions was similar to that in those with unilateral (aryepiglottic fold) lesions. Supraglottic laryngectomy, when properly selected, did not compromise primary control in the larynx. Radiation therapy was ineffective in controlling metastasis to the contralateral side of the neck in 16 of 99 patients (16 %). Therefore, routine bilateral neck dissection should be considered in the surgical treatment of supraglottic carcinoma for control of regional disease.