Surgical treatment of early‐stage carcinoma of the oral tongue—would adjuvant treatment be beneficial?

Abstract

A group of 97 patients with clinical stage I and stage II squamous carcinoma of the oral tongue, treated by partial glossectomy alone, has been reviewed to define prognostic indicators. Sixty-seven patients were staged T1N0 and 30 were T2N0. Disease recurred in 28 patients (27%) and the most common site of failure was the ipsilateral neck (21%). The incidence of initial recurrence did not vary significantly with patient age, sex, T-stage, or when tumor size was examined in other subdivisions. The presence of perineural invasion significantly increased recurrence rate (P = 0.003) and decreased survival (P = 0.002). Disease-free survival at 5 yr was 73% for patients with T1 tumors, and 62% for T2 tumors. This difference was not significant. In this low-risk patient population with early stage carcinoma of the oral tongue, partial glossectomy is adequate treatment in most cases. However, we recommend postoperative radiation therapy to the primary site and ipsilateral neck for patients with perineural invasion. No evidence could be found to support adjuvant local therapy or elective neck treatment in the remaining patients.

Prognostic Factors for Local Control and Survival of Cancer of the Oral Tongue a retrospective analysis of 230 cases in Western Sweden

“…We did not find any sex difference or difference between age-groups, in contrast to Dearnaley et al (8), who found significantly poorer results for patients under 40 years of age. A local control rate of 59% and 5-year survival rate of 37% are not excellent but are similar to other reported results (13)(14)(15).…”

“…Nor did histological differentiation have any prognostic impact, in contrast to what others have found (7, 8). Several authors have shown that tumour thickness in mm (9-1 1) and perineural infiltration (10,12,13) determined from a histological specimen, are significantly correlated with prognosis. However, to make use of these findings, planned treatment with radical surgery would have to be done without knowing the result.…”

Molecular Pathways: Emerging Pathways Mediating Growth, Invasion, and Metastasis of Tumors Progressing in an Irradiated Microenvironment

“…The TBE is a local effect, as it is only observed for tumors injected inside of the irradiated bed (14). These observations are of clinical relevance, as radiotherapy improves local tumor control, but tumor recurrences within a preirradiated field are often associated with an elevated risk of metastasis and poor prognosis (2,(15)(16)(17).…”

The Danish national guidelines for treatment of oral squamous cell carcinoma

“…The precondition for a standardised treatment comprises the use of well-characterised definitions and methods. Especially, the definition of a clear radical resection as well as the N0 neck is varying or is not always defined explicitly when reviewing the literature [8,9,15,18]. Moreover, the access to CT and especially MRI is still limited in Denmark.…”