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Twenty-eight tongue cancer patients, who underwent an excisional biopsy, were analyzed, focusing on the mode of cancer invasion and the clinical implications. According to the T classification, there were 19 cases of T1, 8 cases of T2, and 1 case of T3. Eighteen of these cases showed an exophytic growth pattern and 10 cases an endophytic growth pattern. Surgical margins were evaluated and found to be negative in all cases. Five cases had a recurrence at the primary site; 4 out of 5 cases had a recurrence at the superficial portion of the tongue, while the other had a recurrence in the deep portion of the tongue with cervical metastases. The mode of cancer invasion in the first resected specimens was 1 case of Grade 1, 2 cases of Grade 2, and 2 cases of Grade 3. Local control after re-excision was achieved in all cases. On the other hand, four cases, including 2 cases of Grade 4C and 2 cases of Grade 4D mode of cancer invasion, subsequently developed cervical metastases. Control above the clavicles was obtained in 3 of these 4 cases by neck dissection. Two of these 3 cases subsequently developed distant metastases to the lung, with Grade 4D mode of cancer invasion. The crude survival rate for the 28 cases was 92.9%(Ao: 25 cases, Ac: 1 case, Dc: 2 cases).If a sufficient margin is taken based on detailed observation of the tumor, then excisional biopsy for tongue cancer may be useful in the treatment of small, superficial lesions. However, patients with highly invasive tumors (Grade 4) require that careful attention is paid to secondary cervical metastasis.

Therapeutic outcome in patients with tongue cancer who underwent excisional biospy: relation to mode of cancer invasion.