Changing trends in the management of squamous carcinoma of the tongue.
An analysis of 412 patients with primary squamous carcinoma of the tongue seen from 1969 through 1978 reveals that the age and clinical stage of patients with tongue cancer have remained constant when compared with previous reports from our hospital. The proportion of female patients has increased, and we are seeing more patients with tumors located in the base of the tongue. Treatment methods are changing. Mandible-sparing procedures were used more often, and significantly more patients received primary and adjuvant radiotherapy in the early study period. At the same time, there were fewer composite neck, tongue, and jaw resections and fewer laryngectomies, although more patients had elective treatment of the neck. The overall determinate cure rate has not changed since the 1957 through 1963 period. Age, sex, and adjuvant radiotherapy did not seem to affect survival. When patients with oral tongue primary lesions were compared with those with tumors in the base of the tongue, the prognosis seemed to be better in those with oral primary lesions when the patient had stage I or II disease. Finally, patients with tongue cancer have at least a 1 in 5 chance of development of a second aerodigestive tract malignancy and require lifelong scrutiny. Although current therapy results in lower morbidity, the proportions of patients with stage III and IV tumors remain high, and the cure rates remain disappointingly stable.
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors; D014062:Tongue Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery