WASHINGTON Surgical resection is an effective treatment for primary squamous cell carcinoma arising on the tongue, K. Matsuura, M.D., reported at the Sixth International Conference on Head and Neck Cancer.
Of 313 patients who were evaluated for malignant tongue tumors from July 1992 through June 2000 at the National Cancer Center Hospital East in Kashiwa, Japan, 274 had squamous cell carcinoma (SCC) of the tongue. These 274 patients, with a median age of 59 years, had a median follow-up of 65 months. At presentation, 35% of the patients had stage III or IV SCC, while 28% of patients overall had a nodal metastasis at the first treatment, said Dr. Matsuura of the division of head and neck surgery at the hospital.
Surgical resection of the primary tumor was the only treatment modality in 95% of cases; the remaining 5% received either chemotherapy alone or chemotherapy followed by surgery.
Primary lymph node-negative carcinoma of the tongue was resected to a safety margin of 10 mm without prophylactic dissection of the neck. But conservative neck dissection was indicated in lymph node-negative patients who underwent surgery with the pull-through method and/or reconstruction, he said, as well as in node-positive patients.
Tumors recurred in 37% of stage I, 44% of stage II, 57% of stage III, and 58% of stage IV cases. A total of 59% of recurrences took place within 6 months of treatment. By 12 months, 77% of tumor recurrences had happened; and by 24 months, 90% of the recurrences had developed. Recurrences were twice as likely in lymph nodes of the neck than at the primary tumor site, Dr. Matsuura pointed out at the meeting, which was sponsored by the American Head and Neck Society.