Analysis Of Treatment Results For Oral Tongue Squamous Cell Carcinoma

Objectives: To analyze the results of treatment of oral tongue squamous cell carcinoma with different treatment modalities.Method: Two hundred and ten patients with oral tongue squamous cell carcinoma treated with curative intent from 1985 to 2004 in this hospital were reviewed retrospectively. Treatment modalities included surgery alone/S, radiotherapy alone/R, preoperative radiotherapy plus surgery/R＋S, and surgery plus postoperative radiotherapy/S＋R. Five-year cumulative observed survival rate (COS), cumulative disease-specific survival rate (CDSS), lymph nodes metastasis rate and local and regional control rates of different groups were calculated, then significant prognostic factors were identified.Results: Five-year COS and CDSS rates for the whole group were 61.1% and 65.9%, respectively. The 5-year CDSS rates for early stage diseases (stageⅠandⅡ) were 90.3% for S group, 71.2% for R group, 85.9% for R＋S group, and 88.9% for S＋R group. While for advanced stage diseases (stageⅢandⅣ), they were 72.7%, 23.5%, 61.4%o and 63.2%, respectively. The 5-year local control rate was 79.5%, and regional control rate, 87.3%. R＋S group had higher mandible resection and reconstruction rates, more radical neck dissections and operative complications than S＋R group. Local recurrence rates for early stage diseases were 3.3% for S group, 32.1% for R group, 4.8% for R＋S group, 12.5% for S＋R group. While for advanced stage diseases, they were 11.1%, 69.2%, 27.2%, and 23.1%, respectively. For primary operative patients, lymph nodes metastasis rate was 46.7% and metastasis rates to levelⅠ-Ⅴwere 21.3%, 33.3%, 20.0%, 5.3%, and 1.3%, respectively. Significant improvement in CDSS was seen in patients with local and regional control, early clinical stage, young age, and free from distant metastasis. Clinical stage and treatment modality were significant factors for local control.Conclusions: Surgery alone is recommended for early stage diseases of oral tongue cancer. Advanced stage diseases should be treated with combined therapy. Complete resection followed by radiotherapy is preferred. Elective neck dissection of levelⅠ-Ⅳwas recommended for early N stage diseases.