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Symposium on malignancy. II. Occult regional metastasis: Carcinoma of the oral tongue
Author(s) -
Lee J. G.,
Litton Ward B.
Publication year - 1972
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-197207000-00017
Subject(s) - medicine , occult , tongue , incidence (geometry) , neck dissection , metastasis , carcinoma , malignancy , surgery , survival rate , gastroenterology , radiology , cancer , pathology , physics , alternative medicine , optics
Review of charts of 158 patients with carcinoma of the oral tongue revealed 108 (68 percent) were clinically free of cervical metastasis upon presentation. Patients who were found to have microscopic metastases after elective neck dissection and patients who developed cervical metastases but never a local recurrence were said to have occult regional metastases. The incidence of occult metastases was 23 percent with no difference between T 1 , T 2 , and T 3 lesions. Determinant survival rates of the T 1 N 0 M 0 groups were 83 percent and 57 percent at two and five years respectively. Survival rates of the T 1 N 0 M 0 patients who had occult metastases were comparable (82 percent and 50 percent respectively). Survival rates of patients with T 2 N 0 M 0 and T 3 N 0 M 0 lesions with occult metastases were lower than for all patients in each of the two groups. The incidence of local recurrence in these same 108 patients was 27 percent with the incidence highest in the T 2 N 0 M 0 group (31 percent). Survival rates of these patients, especially of those who developed regional metastases, were lower in all three groups of patients. The combined use of pre‐operative irradiation with cobalt 60 followed by en bloc resection of the primary tumor with the regional lymphatics has been very effective to date. The following conclusions are based on retrospective study of carcinoma of the oral tongue.1 The incidence of occult regional metastasis is the same for T 1 and T 2 primary cancers of the oral tongue. 2 To date, combined therapy is resulting in higher survival rates in patients with larger oral tongue carcinomas. 3 To increase the probability of cure, elective treatment of regional lymphatics either by radical neck dissection or irradiation should be considered in the treatment of T 1 N 0 M 0 epidermoid carcinoma of the oral tongue.