Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-28T08:08:43.074Z Has data issue: false hasContentIssue false
  • English
  • Français

Squamous cell carcinoma of the oral tongue: a 25-year, single institution experience

Published online by Cambridge University Press:  30 June 2008

M S Mosleh-Shirazi ,
M Mohammadianpanah  and
M A Mosleh-Shirazi
M S Mosleh-Shirazi
Affiliation:
Department of Radiotherapy, Namazi Hospital, Shiraz University of Medical Sciences, Iran School of Medicine, University of Birmingham, UK
M Mohammadianpanah*
Affiliation:
Department of Radiotherapy, Namazi Hospital, Shiraz University of Medical Sciences, Iran
M A Mosleh-Shirazi
Affiliation:
Department of Radiotherapy, Namazi Hospital, Shiraz University of Medical Sciences, Iran
*
Address for correspondence: Dr Mohammad Mohammadianpanah, Department of Radiation Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz 71936-13311, Iran. Fax: +98 711 6260135 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim:

To report the characteristics, prognostic factors and treatment outcomes of 102 patients with squamous cell carcinoma of the oral tongue treated and followed up at a single institution over a 25-year period.

Patients and methods:

This retrospective study was carried out by auditing the medical records of 102 patients diagnosed with squamous cell carcinoma of the oral tongue and treated at our institution between 1982 and 2007. Patient follow up ranged from nine to 310 months (median 35 months). Fifty per cent of the patients were treated with surgery followed by a combination of chemotherapy and radiotherapy (43.1 per cent received concurrent chemoradiation and 6.9 per cent received sequential chemotherapy and radiotherapy), whereas 29.4 per cent received surgery followed by adjuvant radiotherapy alone. The remaining patients (20.6 per cent) did not undergo surgery and were treated with definitive radiotherapy with or without chemotherapy.

Results:

There were 48 men and 54 women. The age at presentation was 19–85 years (median 57 years). The peak incidence was observed between 60 and 70 years. Resection margins were clear in 75 per cent of patients and involved in 25 per cent. Stage I disease was found in 11.8 per cent of patients, stage II in 34.3 per cent, stage III in 22.5 per cent and stage IV in 31.4 per cent. The five-year disease-free survival and overall survival were 65.7 and 72.5 per cent, respectively. Thirty-five patients suffered recurrence after treatment, 74.0 per cent of them at the site of initial cervical nodal involvement. Univariate analysis for overall survival revealed the following as prognostic factors: treatment schedule (surgical vs non-surgical; p < 0.001); age (<60 years vs ≥60 years; p = 0.038); extent of cervical lymph node involvement (p = 0.015); primary tumour stage (p < 0.001); node stage (p = 0.034); and disease stage (p = 0.013). However, on multivariate analysis, only non-surgical treatment (p = 0.001) and advanced disease stage (p = 0.05) were found to have a negative influence on survival.

Conclusions:

Our limited data suggest that, in Iran, squamous cell carcinoma of the oral tongue tends to present at a locally advanced stage, with a high frequency of locoregional failure and a poor outcome. Combined modality therapy should be considered for the majority of patients with squamous cell carcinoma of the tongue.

Keywords

Tongue NeoplasmsSquamous Cell CarcinomaPrognosisSurgeryRadiotherapyIran
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 1 , January 2009 , pp. 114 - 120
Copyright
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Prince, S, Bailey, BM. Squamous carcinoma of the tongue: review. Br J Oral Maxillofac Surg 1999;37:164–74CrossRefGoogle ScholarPubMed
2 Lam, L, Logan, RM, Luke, C, Rees, GL. Retrospective study of survival and treatment pattern in a cohort of patients with oral and oropharyngeal tongue cancers from 1987 to 2004. Oral Oncol 2007;43:150–8CrossRefGoogle Scholar
3 Zwetyenga, N, Majoufre-Lefebvre, C, Siberchicot, F, Demeaux, H, Pinsolle, J. Squamous-cell carcinoma of the tongue: treatment results and prognosis [in French]. Rev Stomatol Chir Maxillofac 2003;104:10–17Google Scholar
4 Stelow, EB, Mills, SE. Squamous cell carcinoma variants of the upper aerodigestive tract. Am J Clin Pathol 2005;124 Suppl:S96–109Google ScholarPubMed
5 Lee, CC, Ho, HC, Chen, HL, Hsiao, SH, Hwang, JH, Hung, SK. Squamous cell carcinoma of the oral tongue in young patients: a matched-pair analysis. Acta Otolaryngol 2007;127:1214–17CrossRefGoogle ScholarPubMed
6 El-Husseiny, G, Kandil, A, Jamshed, A, Khafaga, Y, Saleem, M, Allam, A et al. Squamous cell carcinoma of the oral tongue: an analysis of prognostic factors. Br J Oral Maxillofac Surg 2000;38:193–9CrossRefGoogle ScholarPubMed
7 Davidson, BJ, Root, WA, Trock, BJ. Age and survival from squamous cell carcinoma of the oral tongue. Head Neck 2001;23:273–9CrossRefGoogle ScholarPubMed
8 Gorsky, M, Epstein, JB, Oakley, C, Le, ND, Hay, J, Stevenson-Moore, P. Carcinoma of the tongue: a case series analysis of clinical presentation, risk factors, staging, and outcome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98:546–52CrossRefGoogle Scholar
9 Atula, S, Grenman, R, Laippala, P, Syrjanen, S. Cancer of the tongue in patients younger than 40 years. A distinct entity? Arch Otolaryngol Head Neck Surg 1996;122:1313–19CrossRefGoogle ScholarPubMed
10 Davidson, BJ, Root, WA, Trock, BJ. Age and survival from squamous cell carcinoma of the oral tongue. Head Neck 2001;23:273–9CrossRefGoogle ScholarPubMed
11 Funk, GF, Karnell, LH, Robinson, RA, Zhen, WK, Trask, DK, Hoffman, HT. Presentation, treatment, and outcome of oral cavity cancer: a National Cancer Data Base report. Head Neck 2002;24:165–80CrossRefGoogle ScholarPubMed
12 Mäkitie, AA, Koivunen, P, Keski-Säntti, H, Törnwall, J, Pukkila, M, Laranne, J et al. Oral tongue carcinoma and its treatment in Finland. Eur Arch Otorhinolaryngol 2007;264:263–7CrossRefGoogle ScholarPubMed
13 Kuriakose, M, Sankaraarayanan, M, Nair, MK, Cherian, T, Sugar, AW, Scully, C et al. Comparison of oral squamous cell carcinoma in younger and older patients in India. Eur J Cancer B Oral Oncol 1992;28:113–20CrossRefGoogle Scholar
14 Schantz, SP, Byers, RM, Goepfert, H, Shallenberger, RC, Beddingfield, N. The implication of tobacco use in the young adult with head and neck cancer. Cancer 1988;62:1374–803.0.CO;2-M>CrossRefGoogle Scholar
15 Bell, RB, Kademani, D, Homer, L, Dierks, EJ, Potter, BE. Tongue cancer: is there a difference in survival compared with other subsites in the oral cavity? J Oral Maxillofac Surg 2007;65:229–36CrossRefGoogle Scholar
16 Tan, EH, Adelstein, DJ, Droughton, ML, Van Kirk, MA, Lavertu, P. Squamous cell head and neck cancer in nonsmokers. Am J Clin Oncol 1997;20:146–50CrossRefGoogle ScholarPubMed
17 Burzynski, NJ, Flynn, MB, Faller, NM, Ragsdale, TL. Squamous cell carcinoma of the upper aerodigestive tract in patients 40 years of age and younger. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1992;74:404–8CrossRefGoogle ScholarPubMed
18 Lo, WL, Kao, SY, Chi, LY, Wong, YK, Chang, RC. Outcomes of oral squamous cell carcinoma in Taiwan after surgical therapy: factors affecting survival. J Oral Maxillofac Surg 2003;61:751–8CrossRefGoogle ScholarPubMed
19 Chen, YK, Huang, HC, Lin, LM, Lin, CC. Primary oral squamous cell carcinoma: an analysis of 703 cases in southern Taiwan. Oral Oncol 1999;35:173–9CrossRefGoogle ScholarPubMed
20 Sargeran, K, Murtomaa, H, Safavi, SM, Vehkalahti, M, Teronen, O. Malignant oral tumors in Iran: ten-year analysis on patient and tumor characteristics of 1042 patients in Tehran. J Craniofac Surg 2006;17:1230–3CrossRefGoogle ScholarPubMed
21 Sargeran, K, Murtomaa, H, Safavi, SM, Vehkalahti, M, Teronen, O. Survival after diagnosis of cancer of the oral cavity. Br J Oral Maxillofac Surg 2008;46:187–91CrossRefGoogle ScholarPubMed
22 Finlay, PM, Dawson, F, Robertson, AG, Soutar, DS. An evaluation of functional outcome after surgery and radiotherapy for intraoral cancer. Br J Oral Maxillofac Surg 1992;30:14–17CrossRefGoogle ScholarPubMed
23 Zelefski, MJ, Harrison, LB, Armstrong, JG. Long term treatment results of postoperative radiation therapy for advanced stage oropharyngeal carcinoma. Cancer 1992;70:2388–953.0.CO;2-M>CrossRefGoogle Scholar
24 Franceschi, D, Gupta, R, Spiro, RH, Shah, JP. Improved survival in the treatment of squamous carcinoma of the oral tongue. Am J Surg 1993;166:360–5CrossRefGoogle ScholarPubMed
25 Fein, DA, Mendenhall, WM, Parsons, JT, McCarty, PJ, Stringer, SP, Million, RR et al. Carcinoma of the oral tongue: a comparison of results and complications of treatment with radiotherapy and/or surgery. Head Neck 1994;16:358–65CrossRefGoogle ScholarPubMed
26 Sessions, DG, Spector, GJ, Lenox, J, Haughey, B, Chao, C, Marks, J. Analysis of treatment results for oral tongue cancer. Laryngoscope 2002;112:616–25CrossRefGoogle ScholarPubMed
27 Pernot, M, Malissard, L, Hoffstetter, S, Luporsi, E, Peiffert, D, Aletti, P et al. The study of tumoral, radiobiological, and general health factors that influence results and complications in a series of 448 oral tongue carcinomas treated exclusively by irradiation. Int J Radiat Oncol Biol Phys 1994;29:673–9CrossRefGoogle Scholar
28 Shah, JP, Andersen, PE. Evolving role of modifications in neck dissection for oral squamous carcinoma. Br J Maxillofac Surg 1995;33:3–8CrossRefGoogle ScholarPubMed
29 Friedlander, PL, Schantz, SP, Shaha, AR, Yu, G, Shah, JP. Squamous cell carcinoma of the tongue in young patients. Head Neck 1998;20:363–83.0.CO;2-W>CrossRefGoogle ScholarPubMed
30 Schrijvers, AHGJ. MAb U36, a novel monoclonal antibody successful in immunotargeting of squamous cell carcinoma of the head and neck. Cancer Res 1993;53:4383–90Google ScholarPubMed
31 Vargas, H, Pitman, KT, Johnson, JT, Galati, LT. More aggressive behavior of squamous cell carcinoma of the anterior tongue in young women. Laryngoscope 2000;110:1623–6CrossRefGoogle ScholarPubMed
32 Popovtzer, A, Shpitzer, T, Bahar, G, Marshak, G, Ulanovski, D, Feinmesser, R. Squamous cell carcinoma of the oral tongue in young patients. Laryngoscope 2004;114:915–17CrossRefGoogle ScholarPubMed
33 Sasaki, T, Moles, DR, Imai, Y, Speight, PM. Clinico-pathological features of squamous cell carcinoma of the oral cavity in patients <40 years of age. J Oral Pathol Med 2005;34:129–33CrossRefGoogle Scholar
34 Lim, YC, Lee, JS, Koo, BS, Kim, SH, Kim, YH, Choi, EC. Treatment of contralateral N0 neck in early squamous cell carcinoma of the oral tongue: elective neck dissection versus observation. Laryngoscope 2006;116:461–5CrossRefGoogle ScholarPubMed
35 Kurita, H, Koike, T, Narikawa, J, Sakai, H, Nakatsuka, A, Uehara, S et al. Clinical predictors for contralateral neck lymph node metastasis from unilateral squamous cell carcinoma in the oral cavity. Oral Oncol 2004;40:898–903CrossRefGoogle ScholarPubMed
36 Deng, LF, Chen, FJ, Zeng, ZY, Wei, MW, Yang, AK, Zhang, Q. Neck management in oral tongue squamous cell carcinoma of stage I: a report of 95 cases [in Chinese]. Ai Zheng 2005;24:204–7Google Scholar
37 Wolfensberger, M, Zbaeren, P, Dulguerov, P, Müller, W, Arnoiux, A, Schmid, S. Surgical treatment of early oral carcinoma – results of a prospective controlled multicenter study. Head Neck 2001;23:525–30CrossRefGoogle ScholarPubMed
38 Schiff, BA, Roberts, DB, El-Naggar, A, Garden, AS, Myers, JN. Selective vs modified radical neck dissection and postoperative radiotherapy vs observation in the treatment of squamous cell carcinoma of the oral tongue. Arch Otolaryngol Head Neck Surg 2005;131:874–8CrossRefGoogle ScholarPubMed
39 Woolgar, JA, Rogers, S, West, CR, Errington, RD, Brown, JS, Vaughan, ED. Survival and patterns of recurrence in 200 oral cancer patients treated by radical surgery and neck dissection. Oral Oncol 1999;35:257–65CrossRefGoogle ScholarPubMed
40 Malone, JP, Stephens, JA, Grecula, JC, Rhoades, CA, Ghaheri, BA, Schuller, DE. Disease control, survival, and functional outcome after multimodal treatment for advanced-stage tongue base cancer. Head Neck 2004;26:561–72CrossRefGoogle ScholarPubMed
41 Fan, KH, Lin, CY, Kang, CJ, Huang, SF, Wang, HM, Chen, EY et al. Combined-modality treatment for advanced oral tongue squamous cell carcinoma. Int J Radiat Oncol Biol Phys 2007;67:453–61CrossRefGoogle ScholarPubMed