Early stage carcinoma of oral tongue: prognostic factors for local control and survival

The purpose of this study was to assess prognostic factors, treatment outcomes and patterns of relapse in patients with early stage (T1-2 NO) squamous cell carcinoma of oral tongue treated primarily by surgery. The medical records of all patients with early stage (T1-2 NO) oral tongue cancer, radically treated at King Faisal Specialist Hospital and Research Center between January 1980 and December 1997, were reviewed. Eighty-five patients were identified for analysis, 38 male and 47 female. With a median Follow-up for surviving patients of 64 months, 5-year actuarial overall, disease-specific (DSS), and relapse-free survival (RFS) were 71, 75, and 63%, respectively. Univariate analysis for DSS showed survival advantage for patients with tumor thickness (TT) of less than or equal to 10 mm (P = 0.0002) and distance from resection margin (DFRM) of > 5 mm (P = 0.005). The effect of TT of less than or equal to 10 mm was maintained (P = 0.001) on multivariate analysis. Higher RFS was observed with TT of less than or equal to 10 mm (P = 0.0002), DFRM of > 5 mm (P = 0.0002) and DFRM of > 10 mm (P = 0.007). On multivariate analysis higher RFS was also found for TT less than or equal to 10 mm (P = 0.01) and DFRM > 5 mm (P = 0.01). Salvage of local tongue recurrence was higher than neck node failure, with 5-year DSS of 71 and 19%. respectively (P = 0.007). Time interval for recurrence showed no significant impact on outcome. In T1-2 NO oral tongue cancer. TT, and DFRM are significant prognostic factors for both local control and survival. Neck node recurrence is associated with poor prognosis and low salvage rate. (C) 2000 Elsevier Science Ltd. All rights reserved.