Source: www.docguide.com
Author: Louise Gagnon

Surgery is effective in achieving local control of tongue cancer, but additional therapy with radiation does not produce a significant advantage in regional disease control, according to a study presented here at the 2nd World Congress of the International Academy of Oral Oncology (IAOO).

The review, presented on July 9, identified 282 patients (mean age, 59 years) who were treatment naïve and then received treatment for squamous cell carcinoma of the tongue between 1994 and 2004 at the Princess Margaret Hospital, Toronto, Ontario.

“These were newly diagnosed patients who were previously untreated,” said David Goldstein, MD, Head and Neck Surgical Oncology, Department of Surgical Oncology, University Health Network and Princess Margaret Hospital and Department of Otolaryngology, Head and Neck Surgery, University of Toronto, Toronto, Ontario. “We wanted to analyse the outcomes and patterns of failure at our institution.”

The medical literature suggests a wide variability in outcomes in the management of squamous cell carcinoma of the oral tongue, according to Dr. Goldstein.

A total of 268 (95%) were treated primarily with surgery, and 70 patients (26%) received postoperative adjuvant therapy. The majority of patients were in early stages of cancer. Patients were followed for a median of 4.54 years. The mean tumour thickness was 11 mm. The intent was curative, noted Dr. Goldstein.

A minority of patients did not receive surgery as primary treatment, noted Dr. Goldstein, pointing out they received chemoradiation. “These patients were not medically fit for surgery or refused surgery as primary treatment,” he said.

Investigators found the overall 5-year survival rate was 62%, and the 5-year disease-free survival was 47%.

Investigators did not find the use of alcohol or tobacco, age, or gender to be predictive of disease-free survival, but they did conclude that advanced pathologic T stage and N stage were associated with disease-free survival in a significant way. They found local and regional control rates of recurrence were 79% and 69.5%, respectively.

Surgery is effective in treating squamous cell carcinoma of the tongue base, particularly for early lesions, noted Dr. Goldstein. Despite the availability of aggressive treatment modalities, patients with tongue cancer continue to experience local and regional recurrences of disease, he added.

Notes:
1. Presentation title: Outcomes in Patients With Tongue Cancer Treated at the Princess Margaret Hospital From 1994 to 2004. Abstract 055. Presented at the 2nd World Congress of the International Academy of Oral Oncology (IAOO).