Treatment outcomes and prognostic factors in oral tongue cancer: a 20-year retrospective study at the National Cancer Center, South Korea

Abstract

Objectives This study aimed to analyze the treatment outcomes and to evaluate the clinicopathological prognostic factors of oral tongue cancer. Patients and Methods We retrospectively analyzed treatment results and prognostic factors in 205 patients with oral tongue squamous cell carcinoma who were admitted to the National Cancer Center, South Korea, between January 2001 and December 2020. The patients were treated with surgery and postoperative, definitive radiotherapy (RT) or chemoradiotherapy (CRT). Results Eighteen patients (8.8%) were treated with curative RT or CRT, while the rest (91.2%) were treated with surgery with or without postoperative RT or CRT. The median follow-up period was 30 months (range, 0-234 months). The 5-year overall survival (OS) and 5-year disease-free survival (DFS) were 72% and 63%, respectively. Multivariate analysis revealed that a positive neck nodal status (N1, N2-3) was significantly associated with poorer 5-year OS and DFS, while perineural invasion was associated with poorer 5-year DFS. Conclusion Cervical metastasis and perineural invasion are significant prognostic predictors, and combination treatments are necessary for improving OS and DFS in patients with these factors.

Prognostic factors in surgically treated tongue squamous cell carcinoma in stage T1‐2N0‐1M0: A retrospective analysis

“…Several articles also observed same effect, showing that pathologic differentiation was associated with OS 13 and DFS 41,43 in oral cancer. Kim et al 25 . have reported pathologic differentiation as an independent factor for OS in patients of oral tongue cancer.…”

“…Several articles also observed same effect, showing that pathologic differentiation was associated with OS 13 and DFS 41,43 in oral cancer. Kim et al 25 have reported pathologic differentiation as an independent factor for OS in patients of oral tongue cancer. Thus, histological grade may be a potential factor indicating the need for postoperative adjuvant therapy, and the patients with a lower degree of differentiation may need more stringent follow-up after treatment.…”

The modified Polsby–Popper score, a novel quantitative histomorphological biomarker and its potential to predict lymph node positivity and cancer‐specific survival in oral tongue squamous cell carcinoma

“…10 Moreover, PNI and LVI, which proved to possess a high discriminatory potential, have been reported to be present in approximately 20%-40% and 10%-30% of the OSCC cases, respectively. 6,[21][22][23] This implies that in more than half of the OSCC cases, an additional descriptor of tumor aggressiveness would be of utmost importance, and that this descriptor should ideally be interpreted on a continuous scale, as converting inherently non-categorical into categorical data will potentially result in loss of information through a priori assumptions. 24 The approach to diagnosing and confirming cancer through microscopic examination of resected tissue has remained largely unchanged since the late 1800s.…”

“…While Kim et al. emphasized the excellent survival of appropriately treated TSCCs according to statistical analyses of the Surveillance, Epidemiology, and End Results (SEER) database, other recent reports have shown a modest 5‐year disease‐free survival of 63% across all T‐categories 5,6 . Moreover, tumor recurrence occurs in up to 30% of early stage TSCCs 7 .…”

“…However, these models have a limited input in terms of features characteristic of the intrinsic biological behavior of OSCC and do not take into account the pattern of invasion (POI), although a significant association between POI and nodal status, a strong predictor of OSCC, has been described 10 . Moreover, PNI and LVI, which proved to possess a high discriminatory potential, have been reported to be present in approximately 20%–40% and 10%–30% of the OSCC cases, respectively 6,21–23 . This implies that in more than half of the OSCC cases, an additional descriptor of tumor aggressiveness would be of utmost importance, and that this descriptor should ideally be interpreted on a continuous scale, as converting inherently non‐categorical into categorical data will potentially result in loss of information through a priori assumptions 24 …”