Long-term regional control and survival in patients with "low-risk," early stage oral tongue cancer managed by partial glossectomy and neck dissection without postoperative radiation: The importance of tumor thickness Journal Article

  

Authors:	Ganly, I.; Goldstein, D.; Carlson, D. L.; Patel, S. G.; O'Sullivan, B.; Lee, N.; Gullane, P.; Shah, J. P.
Article Title:	Long-term regional control and survival in patients with "low-risk," early stage oral tongue cancer managed by partial glossectomy and neck dissection without postoperative radiation: The importance of tumor thickness
Abstract:	Background: The objectives of this study were to determine the incidence of locoregional failure in patients with low-risk, early stage oral tongue squamous cell cancer (OTSCC) who undergo partial glossectomy and ipsilateral elective neck dissection without receiving postoperative radiation. METHODS: A combined database of patients with OTSCC who received treatment at Memorial Sloan-Kettering Cancer Center and Princess Margaret Cancer Center from 1985 to 2005 was established. In total, 164 patients with pathologic T1-T2N0 OTSCC who underwent partial glossectomy and ipsilateral elective neck dissection without postoperative radiation were identified. Patient-related, tumor-related, and treatment-related characteristics were recorded. Local recurrence-free survival, regional recurrence-free survival, and disease-specific survival were calculated by the Kaplan-Meier method. Predictors of outcome were analyzed by univariate and multivariate analysis. RESULTS: At a median follow-up of 66 months (range 1-171 months), the 5-year rates of local recurrence-free survival, regional recurrence-free survival, and disease-specific survival were 89%, 79.9%, and 85.6%, respectively. Regional recurrence was ipsilateral in 61% of patients and contralateral in 39% of patients. The regional recurrence rate was 5.7% for tumors <4 mm and 24% for tumors ≥4 mm. Multivariate analysis indicated that tumor thickness was the only independent predictor of neck failure (regional recurrence-free survival, 94% vs 72% [P =.02] for tumors <4 mm vs ≥4 mm, respectively). Patients who developed recurrence in the neck had a significantly poorer disease-specific survival compared with those who did not (33% vs 97%; P <.0001). CONCLUSIONS: Patients with low-risk, pathologic T1-T2N0 OTSCC had a greater than expected rate of neck failure, with contralateral recurrence accounting for close to 40% of recurrences. Failure occurred predominantly in patients who had primary tumors that were ≥4 mm thick. Cancer 2013. © 2013 American Cancer Society.
Keywords:	prognostic factors; outcome; tumor thickness; oral tongue cancer
Journal Title:	Cancer
Volume:	119
Issue:	6
ISSN:	0008-543X
Publisher:	Wiley Blackwell
Date Published:	2013-03-15
Start Page:	1168
End Page:	1176
Language:	English
DOI:	10.1002/cncr.27872
PROVIDER:	scopus
PUBMED:	23184439
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84874689757&partnerID=40&md5=a5fd2906c6c8702f4810a68839525bd5
Notes:	--- - "Export Date: 1 April 2013" - "CODEN: CANCA" - "Source: Scopus"

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