Squamous cell carcinoma of the oral tongue: an analysis of prognostic factors

Aim: To identify the prognostic significance of different factors in patients with squamous cell carcinoma of the tongue. Patients and methods: Seventy-seven patients with carcinoma of the tongue were treated radically at the King Faisal Specialist Hospital and Research Centre between 1980 and 1989, Twenty patients (26%) were treated by resection alone, 11 (14%) with radiotherapy alone, and 46 (60%) with combined resection and radiotherapy. Results: forty-seven patients (61%) had T1-2, 28 (36%) T3-4, and two T-x tumours, The regional nodes were clear in 53 (69%) and contained metastases in 24 patients (31%), Thirty patients (39%) developed recurrences, which were local in 9, regional in 14, locoregional in 5, and locoregional with metastatic disease in 2, The five and 10-year overall actuarial survival for all patients were 65% and 53%, respectively, and the corresponding relapse-free survival 56% and 50%. Univariate and multivariate analyses were done of seven variables - age (<40 compared with greater than or equal to 40 Sears), sex, chewing tobacco use, smoking, TNM stage, surgical margins (clear or invaded), and treatment (resection, radiotherapy, or the combination), On univariate analysis chewing tobacco (P=0.04), smoking (P=0.01), invaded resection margins (P=0.04), involved regional lymph nodes (P=0.009), T4 tumours, and patients treated with radiotherapy alone (P=0.001) were associated with poor overall survival. Factors associated with shorter relapse-free survival were age >40 (P=0.03), smoking tobacco (P=0.04), invaded resection margins (P=0.01), and smoking (P=0.01), On multivariate analysis, invaded resection margins and smoking (P=0.04)(P=0.02) were associated with shorter overall survival and relapse-free survival (P=0.03) and (P=0.01), while chewing tobacco independently influenced relapse-free survival only (P=0.03). Conclusion: Invaded resection margins and smoking were the only independent prognostic factors that affected both overall and relapse-free survival. Those who chewed tobacco were at high risk of locoregional failure.