Background and objectives: The most frequent reported cause of treatment failure in early oral tongue cancer is regional recurrence. We analyzed our data from the recent two decades to review patterns of recurrence in our patient cohort.
Methods: Medical files of patients with oral tongue squamous cell carcinoma treated at the Chaim Sheba medical center, Israel, during 1990–2009 were reviewed.
Results: Fifty two patients were staged as T1-2 N0 M0. All patients were followed for at least 24 months. The mean age at diagnosis was 59.85 years. Twenty eight (53.8%) patients were females. 48 patients (92.3%) were treated with partial glossectomy and three (5.8%) with hemi-glossectomy. One patient received brachytherapy. Forty seven patients (90.4%) underwent ipsilateral neck Dissection. Occult nodal disease was found in 11 (21.2%) patients. Of these, 6 patients (54.5%) had evidence of (extra capsular spread (ECS). Overall, 14 (26.9%) patients had recurrence, 8 (15.4%) with local (LR) and 6 (11.5%) with regional recurrence (RR). Six of the patients in the LR group had close or positive resection margins and >4 mm depth of invasion. Seven of the 8 patients with LR had T2 tumors. All the 6 patients with RR underwent primary selective or modified radical neck dissection. Univariate analysis showed a significant ( P < 0.05) correlation between following parameters: age, stage, margins, Depth of invasion (>4 mm), pathological risk score, pathological lymph nodes with recurrence. The 2 year DSS, OS and DFS rates were 84.1%, 78.8%, and 76% respectively. Our findings raise the discussion whether or not T2, N0, M0 tumors should be considered early stage.
Conclusions: T2 tumors of the oral tongue may be highly aggressive, and present not only a higher risk for occult metastasis but also for local recurrences consequently requiring wider and more deliberate resections such as hemi-glossectomy for better local control.
Key words : recurrence; squamous cell carcinoma; tongue