A retrospective study in Head and Neck Oncology (May 21, 2011) provides new treatment strategies for primary tumor disease and tumor recurrence in patients with tongue cancer.
The authors, from the department of oral and maxillofacial surgery at the Hannover Medical School in Germany, present a clinical review of their experience with tongue cancer by looking at 341 patients with squamous cell carcinoma of the tongue who were treated in their department between 1980 and 2009 with an average follow-up of 5.2 years.
Of the 341 patients (226 men, 115 women; average age at diagnosis 58.8 years), 309 received surgical treatment, which was combined in nearly 10% of cases with neoadjuvant and in nearly 20% with postoperative radiochemotherapy. A total of 32 patients were excluded from surgery and received primary radiochemotherapy.
Here are some of the results:
- In the surgery group, local and regional recurrence occurred in 74 patients (23.9%) and 63 patients (20.4%), respectively, leading to a total locoregional recurrence rate of 37.2% after an average duration of 1.6 years.
- Lymph node status (N), extracapsular spread, and clear margins were identified as the dominant factors for survival, which was calculated to be 54.5% after five years.
"We recommend categorical bilateral neck dissection in order to reliably remove occult lymph node metastases," the authors concluded. "Adjuvant treatment modalities should be applied more frequently in controlled clinical trials and should generally be implemented in cases with unclear margins and lymphatic spread."
