Abstract
The aim of the present study was to provide insight into various demographic, clinical, and management profile of Indian patients with oral tongue squamous cell cancer (OTSCC). All the OTSCC patients who had undergone surgical treatment during 1995 to 2010 at a tertiary care center in North India were considered for the present study. The details of the patients were retrieved from a prospectively maintained computerized database. A total of 124 patients were included in the present study. Mean age of the patients was 50.4 ± 12.0 years. Lateral border of the tongue was the most common sub-site involved in 110 (88.7%) patients. Neck nodes were clinically palpable in 56.4% patients. Hemiglossectomy and anterior partial glossectomy were common surgical procedure undertaken in 57.2 and 25.8% patients. Negative resection margin was achieved in 97.5% patients. Pathological neck metastasis was seen in 40.3% patients. Occult neck metastasis was present in 25.9% patients among clinical N0 neck. At a mean follow-up of 29.8 months (SD 3.1), 20.1% developed disease relapse and 4.0% patients developed second primaries. Kaplan-Meier analysis estimated a 5-year disease-free survival of 81.5% and a 5 years overall survival of 78.6%. Cox proportional regression analysis predicted tumor size and number of positive nodes to be independent predictive variables for disease recurrence. Quality controlled surgery, coupled with adjuvant treatment when required, provides a safe and effective treatment of OTSCC with a good disease-free survival and loco-regional control.
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Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C et al GLOBOCAN 2012 v1.0, cancer incidence and mortality worldwide: IARC cancer base No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer 2013 [cited 2015 Jun 25]. Available from: http://globocan.iarc.fr
Krishnamurthy A, Ramshankar V (2013) Early stage oral tongue cancer among non-tobacco users--an increasing trend observed in a south Indian patient population presenting at a single centre. Asian Pac J Cancer Prev 14:5061–5065
Deo S (2011) Computerized clinical database development in oncology. Indian J Palliat Care 17:S2–S3
Kobayashi Y, Karasawa K, Komiya Y, Hanyu N, Okamoto M, Chang T-C et al (2007) Therapeutic results for 100 patients with cancer of the mobile tongue treated with low dose rate interstitial irradiation. Anticancer Res 27:1689–1692
Bhalavat R, Mahantshetty U, Tole S, Jamema S (2009) Treatment outcome with low-dose-rate interstitial brachytherapy in early-stage oral tongue cancers. J Cancer Res Ther 5:192
Thiagarajan S, Nair S, Nair D, Chaturvedi P, Kane SV, Agarwal JP et al (2014) Predictors of prognosis for squamous cell carcinoma of oral tongue. J Surg Oncol 109:639–644
Süslü N, Hoşal AŞ, Aslan T, Sözeri B, Dolgun A (2013) Carcinoma of the oral tongue: a case series analysis of prognostic factors and surgical outcomes. J Oral Maxillofac Surg 71:1283–1290
Fan K-H, Lin C-Y, Kang C-J, Huang S-F, Wang H-M, Chen EY-C et al (2007) Combined-modality treatment for advanced oral tongue squamous cell carcinoma. Int J Radiat Oncol Biol Phys 67:453–461
Chen T-C, Wang C-T, Ko J-Y, Lou P-J, Yang T-L, Ting L-L et al (2010) Postoperative radiotherapy for primary early oral tongue cancer with pathologic N1 neck. Head Neck 32:555–561
Lim YC, Choi EC (2007) Unilateral, clinically T2N0, squamous cell carcinoma of the tongue: surgical outcome analysis. Int J Oral Maxillofac Surg 36:610–614
Mantsopoulos K, Psychogios G, Künzel J, Waldfahrer F, Zenk J, Iro H (2014) Primary surgical therapy for locally limited oral tongue cancer. BioMed Res Int 738716
Ganly I, Patel S, Shah J (2012) Early stage squamous cell cancer of the oral tongue--clinicopathologic features affecting outcome. Cancer 118:101–111
Akhtar S, Ikram M, Ghaffar S (2007) Neck involvement in early carcinoma of tongue. Is elective neck dissection warranted? J Pak Med Assoc 57:305–307
Zhang T, Lubek JE, Salama A, Dyalram D, Liu X, Ord RA (2004) Treatment of cT1N0M0 tongue cancer: outcome and prognostic parameters. J Oral Maxillofac Surg 72:406–414
Kokemueller H, Rana M, Rublack J, Eckardt A, Tavassol F, Schumann P et al (2011) The Hannover experience: surgical treatment of tongue cancer--a clinical retrospective evaluation over a 30 years period. Head Neck Oncol 3:27
Shiga K, Ogawa T, Sagai S, Kato K, Kobayashi T (2007) Management of the patients with early stage oral tongue cancers. Tohoku J Exp Med 212:389–396
Byers RM, El-Naggar AK, Lee YY, Rao B, Fornage B, Terry NH et al (1998) Can we detect or predict the presence of occult nodal metastases in patients with squamous carcinoma of the oral tongue? Head Neck 20:138–144
Yuen AP, Lam KY, Wei WI, Lam KY, Ho CM, Chow TL et al (2000) A comparison of the prognostic significance of tumor diameter, length, width, thickness, area, volume, and clinicopathological features of oral tongue carcinoma. Am J Surg 180:139–143
D’Cruz AK, Vaish R, Kapre N, Dandekar M, Gupta S, Hawaldar R et al (2015) Elective versus therapeutic neck dissection in node-negative oral cancer. N Engl J Med 373:521–529
National Comprehensive Cancer Network. NCCN Clinical practice guidelines in oncology (NCCN guidelines®). Head and neck cancers, Version 1. 2015. [Internet]. [cited 2015 Jun 27]. Available from: http://www.nccn.org/professionals/physician_gls/pdf/head-and-neck.pdf
Cooper JS, Pajak TF, Forastiere AA, Jacobs J, Campbell BH, Saxman SB et al (2004) Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 350:1937–1944
Cooper JS, Zhang Q, Pajak TF, Forastiere AA, Jacobs J, Saxman SB et al (2012) Long-term follow-up of the RTOG 9501/intergroup phase III trial: postoperative concurrent radiation therapy and chemotherapy in high-risk squamous cell carcinoma of the Head & Neck. Int J Radiat Oncol Biol Phys 84:1198–1205
Bernier J, Domenge C, Ozsahin M, Matuszewska K, Lefèbvre J-L, Greiner RH et al (2004) Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 350:1945–1952
Bernier J, Cooper JS, Pajak TF, van Glabbeke M, Bourhis J, Forastiere A et al (2005) Defining risk levels in locally advanced head and neck cancers: a comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (#22931) and RTOG (# 9501). Head Neck 27:843–850
Rodrigues PC, Miguel MCC, Bagordakis E, Fonseca FP, de Aquino SN, Santos-Silva AR et al (2014) Clinicopathological prognostic factors of oral tongue squamous cell carcinoma: a retrospective study of 202 cases. Int J Oral Maxillofac Surg 43:795–801
Huang S-F, Kang C-J, Lin C-Y, Fan K-H, Yen T-C, Wang H-M et al (2008) Neck treatment of patients with early stage oral tongue cancer: comparison between observation, supraomohyoid dissection, and extended dissection. Cancer 112:1066–1075
Shim SJ, Cha J, Koom WS, Kim GE, Lee CG, Choi EC et al (2010) Clinical outcomes for T1-2N0-1 oral tongue cancer patients underwent surgery with and without postoperative radiotherapy. Radiat Oncol Lond Engl 5:43
Baek C-H, Son Y-I, Jeong H-S, Chung MK, Park K-N, Ko Y-H et al (2008) Intraoral sonography-assisted resection of T1-2 tongue cancer for adequate deep resection. Otolaryngol--Head Neck Surg 139:805–810
Kodama M, Khanal A, Habu M, Iwanaga K, Yoshioka I, Tanaka T et al (2010) Ultrasonography for intraoperative determination of tumor thickness and resection margin in tongue carcinomas. J Oral Maxillofac Surg 68:1746–1752
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Shukla, N.K., Deo, S.V.S., Garg, P.K. et al. Operable Oral Tongue Squamous Cell Cancer: 15 Years Experience at a Tertiary Care Center in North India. Indian J Surg Oncol 9, 15–23 (2018). https://doi.org/10.1007/s13193-017-0658-x
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DOI: https://doi.org/10.1007/s13193-017-0658-x