Skip to main content

Advertisement

SpringerLink
Log in

Controversies in the management of tongue base cancer

  • Review Article
  • Published:
Irish Journal of Medical Science Aims and scope Submit manuscript

Abstract

Background

Tongue base cancer is one of the most lethal head and neck cancers. There is considerable controversy in the management of this disease with wide variation of opinion within the literature.

Methods

We discuss the presentation, diagnostic and therapeutic strategies which exist in the literature. Articles were reviewed from 1970 to 2007 within the Medline, Pubmed and Cochrane libraries.

Conclusions

Smokers with a history of persistent unilateral neck pain, even in the absence of clinical signs warrant MRI neck imaging. Tongue base cancer organ preservation therapeutic strategies, radiation and concomitant platinum based chemotherapy, currently optimise oncologic and quality of life outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Greene FL, Page DL, Fleming ID et al (2002) AJCC cancer staging manual, American Cancer Society. Springer. 6th Edition

  2. Desai B (2002) Cancer control efforts in the Indian Subcontinent. J Clin Oncol 32:S13–S16

    Google Scholar 

  3. The American Cancer Society Statistics (2007) Surveillance Research

  4. Mackle T, O’Dwyer T (2006) A comparative analysis of anterior versus posterior squamous cell carcinoma of the tongue: a 10-year review. J Laryngol Otol 120:393–396

    Article  PubMed  CAS  Google Scholar 

  5. Gourin C, Johnson J (2001) Surgical treatment of squamous cell carcinoma of the base of tongue. Head Neck 23:653–660

    Article  PubMed  CAS  Google Scholar 

  6. Krus DH, Vastola AP, Huvos AG et al (1993) Surgical management of squamous cell carcinoma of the base of tongue. Am J Surg 166:384–388

    Article  Google Scholar 

  7. Gorsky M, Epstein J, Oakley C et al (2004) Carcinoma of the tongue: a case series analysis of clinical presentation, risk factors, staging, and outcome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 98(5):546–552

    Article  PubMed  Google Scholar 

  8. Mulwafu W, Fagan J, Lentin R et al (2006) Suprahyoid approach to base-of-tongue squamous cell carcinoma. S Afr J Surg 44(3):120, 122–124

    Google Scholar 

  9. Sundaram K, Schwartz J, Har E-I G et al (2005) Carcinoma of the oropharynx: factors affecting outcome. Laryngoscope 115(9):1536–1542

    Article  PubMed  Google Scholar 

  10. Rothman K, Keller A (1972) The effect of joint exposure to alcohol and tobacco on risk of cancer of the mouth and pharynx. J Chronic Dis 25(12):711–716

    Article  PubMed  CAS  Google Scholar 

  11. Born I, Zoller J, Weidauer H (1996) Effects of chronic alcohol drinking on mouth mucosa: a morphometric study. Laryngorhinotologie 75(12):754–758

    Article  CAS  Google Scholar 

  12. Chen P, Kuo C, Pan C et al (2002) Risk of oral cancer associated with human papillomavirus infection, betel quid chewing, and cigarette smoking in Taiwan—an integrated molecular and epidemiological study of 58 cases. J Oral Pathol Med 31(6):317–322

    Article  PubMed  CAS  Google Scholar 

  13. Balaram P, Nalinakumari K, Abraham E et al (1995) Human papillomavirus in 91 oral cancers from Indian betel quid chewers—high prevalence and multiplicity of infections. Int J Cancer 61(4):450–454

    Article  PubMed  CAS  Google Scholar 

  14. Heinzel P, Balaram P, Bernard H (1996) Mutations and polymorphisms in the p53, p21 and p16 genes in oral carcinomas of Indian betel quid chewers. Int J Cancer 68(4):420–423

    Article  PubMed  CAS  Google Scholar 

  15. Dahlgren L, Dahlstrand H, Lindquist D et al (2004) Human Papillomatosis is more common in base of tongue than in mobile tongue cancer and is a favourable prognostic factor in base of tongue cancer patients. In J Cancer 20; 112(6):1015–1019

    Google Scholar 

  16. Haas I, Hoffman T, Engers R et al (2002) Diagnostic strategies in cervical carcinoma of an unknown primary. Eur Arch Otorhinolaryngol 259(6):325–333

    PubMed  Google Scholar 

  17. Harrison L, Ferlito A, Shaha A et al (2003) Current philosophy on the management of cancer of the base of the tongue. Oral Oncol 39:101–105

    Article  PubMed  Google Scholar 

  18. Jones A, Rafferty M, Fenton J et al (2007) Treatment of squamous cell carcinoma of the tongue base: irradiation, surgery or palliation? Ann Otol Rhinol Laryngol 116(2):92–99

    PubMed  Google Scholar 

  19. Yen T, Chang JNGS et al (2005) Staging of untreated squamous cell carcinoma of buccal mucosa with 18F-FDG PET: comparison with head and neck CT/MRI and histopathology. J Nucl Med 46(5):775–781

    PubMed  Google Scholar 

  20. Hermans R, Verwaerde L, Baert A (1994) CT and MRI imaging in tumours of the tongue, tongue base, and floor of mouth: a comparative study. J Belge Radiol 77(2):78–83

    PubMed  CAS  Google Scholar 

  21. Zhu J, Luo J, Lin G (2003) The diagnostic value of computed tomography and magnetic resonance imaging in squamous cell carcinoma of tongue: a comparative study. Shanghai Kuo Qiang Yi Xue 12(5):324–327

    Google Scholar 

  22. Johansen J, Eigtved A, Buchwald C et al (2002) Implication of 18F-fluoro-2-deoxy-d-glucose positron emission tomography on management of carcinoma of unknown primary in the head and neck: a Danish cohort study. Laryngoscope 112(11):2009–2014

    Article  PubMed  Google Scholar 

  23. Hamoir M (2004) Primary surgery for base of tongue and tonsillar regions carcinoma: indications, surgical approaches and resections. Cancer Radiother 1:S61–S67

    Google Scholar 

  24. Han P, Kenneth Hu, Frank D et al (2005) Management of cancer of the base of tongue. Otolaryngol Clin North Am 38:75–85

    Article  PubMed  Google Scholar 

  25. List M, Ritter- Sterr C, Lansky S et al (1990) A performance status scale for head and neck cancer patients. Cancer 1(66):564–569

    Article  Google Scholar 

  26. Harrison L, Zelefsky M, Armstrong J et al (1994) Performance status after treatment for squamous cell cancer of the base of tongue—a comparison of primary radiation therapy versus primary surgery. Int J Radiat Oncol Biol Phys 30:953–957

    PubMed  CAS  Google Scholar 

  27. Bova R, Cheung I, Coman W (2004) Total glossectomy: is it justified? ANZ J Surg 74(3):134–138

    Article  PubMed  Google Scholar 

  28. Mendenhall W, Villaret D, Amdur R et al (2002) Planned neck dissection after definitive radiotherapy for squamous cell carcinoma of the head and neck. Head Neck 24:1012–1018

    Article  PubMed  Google Scholar 

  29. Aldenstein D, Li Y, Adams G et al (2003) An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. J Clin Oncol 21:92–98

    Article  Google Scholar 

  30. Nguyen N, Vos P, Smith H (2007) Concurrent chemoradiation for locally advanced oropharyngeal cancer. Am J Otolaryngol 28(1):3–8

    Article  PubMed  Google Scholar 

  31. Yao M, Smith R, Graham M et al (2005) The role of FDG PET in management of neck metastasis from head-and-neck cancer after definitive radiation treatment. Int J Radiat Oncol Biol Phys 63(4):991–999

    PubMed  Google Scholar 

  32. Brkovich V, Miller F, Karnard A et al (2006) The role of positron emission tomography scans in the management of the N-positive neck in head and neck squamous cell carcinoma after chemoradiotherapy. Laryngoscope 116(6):855–858

    Article  PubMed  Google Scholar 

  33. Doweck I, Robbins K, Mendenhall W (2003) Neck level-specific nodal metastases in oropharyngeal cancer: is there a role for selective neck dissection after definitive radiation therapy? Head Neck 25(11):960–967

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Department of Otolaryngology, Head and Neck Surgery, Mid Western Regional Hospital, Dooradoyle, Limerick, Ireland

    J. P. O’Neill, J. P. Hughes, K. P. Manning & J. E. Fenton

Authors
  1. J. P. O’Neill
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. P. Hughes
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. P. Manning
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. E. Fenton
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. P. O’Neill.

Rights and permissions

Reprints and permissions

About this article

Cite this article

O’Neill, J.P., Hughes, J.P., Manning, K.P. et al. Controversies in the management of tongue base cancer. Ir J Med Sci 178, 1–5 (2009). https://doi.org/10.1007/s11845-008-0214-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-008-0214-3

Keywords

Search

Navigation