[Postoperative recurrence-related factors of 125 patients with cT1-2N0 squamous cell carcinoma of the oral tongue]

Abstract

Background & objective: The treatment pattern for cT1-2N0 squamous cell carcinoma (SCC) of the oral tongue is controversial; the postoperative recurrence rate of the disease is high and the salvage effect is poor. This study was to explore the postoperative recurrence-related factors of cT1-2N0 SCC of the oral tongue, to analyze their effects on the survival, and to seek more reasonable therapeutic modality.

Methods: Clinical data of 125 patients with cT1-2N0 SCC of the oral tongue, treated in Cancer Center of Sun Yat-sen University from Jan. 1992 to Dec. 2000, were reviewed. Of the 125 patients, 58 were at stage T1, 67 were at stage T2; 17 (13.6%) were treated with local operation alone, 53 (42.4%) were treated with both local operation and selective neck dissection, and 55 (44.0%) were treated with operation and chemotherapy and/or radiotherapy. The correlations of disease duration, tumor growth pattern, clinical TNM stage, pathologic grade, occult cervical lymphatic metastasis, tumor invasion depth, treatment methods and neck management to tumor recurrence and prognosis were analyzed.

Results: Forty-one (32.8%) patients had recurrence; the overall 5-year survival rate was 62.59%. The 5-year survival rate was significantly lower in recurrent group than in non-recurrent group (38.74% vs. 74.69%, log-rank=19.27, P<0.001). Disease duration (Chi(2) test, P=0.002), tumor growth pattern (Chi(2) test, P<0.001), neck management (Chi(2) test, P<0.001) and occult cervical lymphatic metastasis (Cox regression, P=0.001) were significantly related to the recurrence of cT1-2N0 SCC of the oral tongue. Tumor invasion depth (Cox regression, P=0.005) and the site of recurrent tumor (Cox regression, P<0.001) were significantly related to the prognosis of cT1-2N0 SCC of the oral tongue.

Conclusion: Disease duration, tumor growth pattern, neck management, and occult cervical lymphatic metastasis are main recurrent factors of cT1-2N0 SCC of the oral tongue; tumor invasion depth and the site of recurrent tumor are important prognostic factors.