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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
Author(s) -
Ganly Ian,
Goldstein David,
Carlson Diane L.,
Patel Snehal G.,
O'Sullivan Brian,
Lee Nancy,
Gullane Patrick,
Shah Jatin P.
Publication year - 2012
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.27872
Subject(s) - medicine , neck dissection , glossectomy , radiation therapy , surgery , univariate analysis , cancer , tongue , multivariate analysis , stage (stratigraphy) , osteoradionecrosis , survival analysis , survival rate , primary tumor , metastasis , pathology , paleontology , biology
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.