Clinical outcome of surgical treatment of T1-2 N0 squamous cell carcinoma of oral tongue with observation for the neck: Analysis of 176 cases

Abstract

Objective:To analyze various demographic, clinical, and histopathologic factors in T1-2 N0 squamous cell carcinoma (SCC) of the oral tongue to define a high-risk group for regional recurrence that will benefit from elective neck dissection.Materials and Methods:Retrospective outcome analysis of a patient cohort without palpable or ultrasound (USG) detectable nodal metastases undergoing per oral wide glossectomy for T1-2 N0 SCC of oral tongue. Patients were followed up using palpation and serial USG neck and fine-needle aspiration cytology.Results:Of the 176 patients, 69 (39%) showed recurrence during follow-up. Fifty-eight cases developed regional neck node metastases, i.e., overall regional node recurrence rate of 33%. Fifty-three (91%) with regional neck node metastases were salvaged successfully with further treatment. In 110 cases with tumor thickness more than 5 mm, 39% cases developed regional neck node metastases. This association was significant with P = 0.0402. Among 44 cases with perineural invasion, 54% developed regional neck node metastases. Similarly in 39 cases with lymphovascular invasion, 61% developed regional neck node metastases. Association of both of these parameters with the development of regional neck node metastases was significant.Conclusion:We recommend prophylactic selective neck dissection in early stage SCC of oral tongue, especially with depth of invasion more than 5 mm, perineural and lymphovascular invasion.

Squamous cell carcinoma of the tongue in patients older than 45 years

“…28,32,33 Our data on nodal involvement (15%) was the same as that for Chinese population 24 and low compared with previously reported data. 32,33 15% of the analyzed SCCTs recurred, this rate was higher to that reported in Chinese patients 24 and similar to the proportion found in the Mäkitie et al study. 33 88.9% of the recurrences were in 61 years and older patients and surprisingly, 44.4% occurred in low-risk patients (non-drinkers non-smokers).…”

“…In several studies, preference for males varied among 48% and 86.4% [18][19][20][21][22][23] and the male frequency we found (53.3%) is within the above-mentioned range. In the literature, mean age is widely variable, it was from 64.3 to 47.5 years, 18,[21][22][23][24] and in our study, it was slightly lower (63.9 years).…”

“…Our results are only similar to those from the Ramdass et al study, 21 but completely different to those found in other studies showing that the WD type was the most common followed by the moderately differentiated type. 18,22,23,24 It is interesting to note, that in this study, a high proportion of low risk patients developed SCCT. This data does not agree with previous studies showing that high risk patients comprise the high proportion of the analyzed samples.…”

“…This data does not agree with previous studies showing that high risk patients comprise the high proportion of the analyzed samples. 21,22,23,24,25,26 Probably these differences may arise from difficulties in the evaluation of tobacco or alcohol consumption levels. This can occur when clinical histories are reviewed retrospectively.…”

Genomic analysis to assess disease progression and recurrence in patients with oral squamous cell carcinoma: – a preliminary study

“…Oral squamous cell carcinoma (OSCC), a subgroup of HNSCC, is primarily attributed to alcohol consumption and tobacco use. Local recurrence and / or regional neck node metastases are significant prognostic indicators of survival for OSCC [3]. Distant metastasis is relatively rare in OSCC compared to other cancer types.…”