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Outcome of patients with early T1 and T2 squamous cell carcinoma of the base of tongue managed by conventional surgery with adjuvant postoperative radiation
Author(s) -
Iyer N. Gopalakrishna,
Kim Leslie,
Nixon Iain J.,
Palmer Frank,
Shah Jatin P.,
Patel Snehal G.,
Ganly Ian
Publication year - 2013
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23071
Subject(s) - medicine , multivariate analysis , transoral robotic surgery , adjuvant , basal cell , univariate analysis , tongue , head and neck squamous cell carcinoma , surgery , oncology , radiation therapy , radiology , head and neck cancer , pathology
Background Existing treatment regimens for squamous cell carcinoma (SCC) of the base of tongue (BOT) favor chemoradiation. However, there is a shifting paradigm toward minimally invasive surgery with adjuvant radiatiotherapy for select tumors. The aim was to report our experience in conventional surgical management with particular focus on T1/T2 tumors, which may be candidates for minimally invasive techniques. Methods Between 1985 and 2005, 128 patients were treated with primary surgery. Overall survival (OS), disease‐specific survival (DSS), and recurrence‐free survival (RFS) rates were calculated using Kaplan–Meier method, and predictive factors analyzed by univariate and multivariate analyses. Results Five‐year OS, DSS, and RFS rates were 60%, 70%, and 61%, respectively. Multivariate analysis showed pathologic T classification and extracapsular extension (ECE) were significant predictors for DSS, whereas T classification remained significant for local recurrence. DSS for T1/T2 tumors ranged from 77% (node‐positive) to 84% (node‐negative). Conclusion T classification and ECE are independent predictors of outcome for BOT SCC. Patients with cT1/T2 tumors had excellent outcome and may be suitable for transoral robotic or endoscopic surgical procedures. © 2012 Wiley Periodicals, Inc. Head Neck, 2013