Squamous cancer of the tongue

Early squamous carcinoma of the tongue (stage I) can be effectively treated by surgery or radiation therapy with good results. In patients with larger, but apparently localized tumors (stage II), we now favor a staging operation (supraomohyoid neck dissection) to select those who require additional treatment directed to the neck. Our preference for patients with advanced tumors (stage III and IV) has shifted to mandible-sparing surgery whenever possible, in combination with postoperative radiation therapy. Using this approach, locoregional tumor control has improved while the morbidity of extraradical surgery and high-dosage radiation therapy has been avoided. This approach may not translate into longer survival times until effective chemotherapy is available to control distant metastases. Meanwhile, there is a need for both public and professional education to increase the proportion of early, curable lesions and promote the necessary changes in lifestyle (i.e., abstinence from alcohol and tobacco) to reduce the incidence of tongue and other cancers of the aerodigestive tract.