Squamous cell carcinoma of the oral tongue: an analysis of prognostic factors.
OBJECTIVE
To identify the prognostic significance of different factors in patients with squamous cell carcinoma of the tongue.


METHODS
Seventy-seven patients with carcinoma of the tongue were treated radically at the King Faisal Specialist Hospital and Research Centre between 1980 and 1989. Twenty patients (26%) were treated by resection alone, 11 (14%) with radiotherapy alone, and 46 (60%) with combined resection and radiotherapy.


RESULTS
Forty-seven patients (61%) had T(1-2), 28 (36%) T(3-4), and two T(x) tumours. The regional nodes were clear in 53 (69%) and contained metastases in 24 patients (31%). Thirty patients (39%) developed recurrences, which were local in 9, regional in 14, locoregional in 5, and locoregional with metastatic disease in 2. The five and 10-year overall actuarial survival for all patients were 65% and 53%, respectively, and the corresponding relapse-free survival 56% and 50%. Univariate and multivariate analyses were done of seven variables - age (<40 compared with >/=40 years), sex, chewing tobacco use, smoking, TNM stage, surgical margins (clear or invaded), and treatment (resection, radiotherapy, or the combination). On univariate analysis chewing tobacco (P=0.04), smoking (P=0.01), invaded resection margins (P=0.04), involved regional lymph nodes (P=0.009), T4 tumours, and patients treated with radiotherapy alone (P=0.001) were associated with poor overall survival. Factors associated with shorter relapse-free survival were age >40 (P=0.03), chewing tobacco (P=0.04), invaded resection margins (P=0.01), and smoking (P=0.01). On multivariate analysis, invaded resection margins and smoking (P=0.04)(P=0.02) were associated with shorter overall survival and relapse-free survival (P=0.03 and (P=0.01), while chewing tobacco independently influenced relapse-free survival only (P=0.03).


CONCLUSIONS
Invaded resection margins and smoking were the only independent prognostic factors that affected both overall and relapse-free survival. Those who chewed tobacco were at high risk of locoregional failure.
El-Husseiny
G
G
Section of Radiation Oncology, Department of Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Kandil
A
A
Jamshed
A
A
Khafaga
Y
Y
Saleem
M
M
Allam
A
A
Al-Rajhi
N
N
Al-Amro
A
A
Rostom
A Y
AY
Abuzeid
M
M
Otieschan
A
A
Flores
A D
AD
D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010947:Plants, Toxic; D011379:Prognosis; D012907:Smoking; D015996:Survival Rate; D014030:Tobacco, Smokeless; D014062:Tongue Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000473:pathology / Q000628:therapy