title: Tongue and buccal mucosa carcinoma: is there a difference in outcome?
abstract: BACKGROUND
  We sought to determine the differences in clinical outcome of tongue and buccal carcinomas.
  
  
  METHODS
  Five-year locoregional control, distant metastasis, and survival rates were examined in 456 patients with tongue cancer and 407 patients with buccal cancer.
  
  
  RESULTS
  Five-year rates for patients with tongue and buccal carcinomas were as follows: local control, 85% and 87% (P = 0.9366); neck control, 81% and 87% (P = 0.0304); distant metastasis, 8% and 14% (P = 0.0052); disease-free survival, 70% and 72% (P = 0.9978); disease-specific survival, 79% and 78% (P = 0.2435), respectively. After stratification according to pathological lymph node status, patients with buccal cancer and pN0/pNx disease (without neck dissection) had a higher 5-year neck control rate than those with tongue cancer (93% versus 86%, P = 0.0115). In contrast, buccal cancer with pN+ disease had a higher 5-year distant metastasis rate compared with tongue cancer (30% versus 18%, P = 0.0231). In pN0/pNx subjects, neck control was predicted by perineural invasion and the absence of neck dissection in tongue cancer, and by poor differentiation in buccal cancer. In pN+ patients, distant metastases were predicted by pT3-4 disease, age at onset ≤40 years, poor differentiation, and pN+ ≥ 5 nodes in tongue cancer, and by poor differentiation and pN+ ≥ 5 nodes in buccal cancer.
  
  
  CONCLUSIONS
  There are significant differences in the failure pattern of tongue and buccal carcinomas. Prognostic models for these malignancies should allow stratification of patients for a risk-adapted approach to treatment.
authors.affiliation: Department of Otorhinolaryngology, Chang Gung University, Taoyuan, Taiwan, Republic of China. liaoct@adm.cgmh.org.tw
authors.forename: Chun-Ta
authors.initials: CT
authors.lastname: Liao
authors.forename: Shiang-Fu
authors.initials: SF
authors.lastname: Huang
authors.forename: I-How
authors.initials: IH
authors.lastname: Chen
authors.forename: Chung-Jan
authors.initials: CJ
authors.lastname: Kang
authors.forename: Chien-Yu
authors.initials: CY
authors.lastname: Lin
authors.forename: Kang-Hsing
authors.initials: KH
authors.lastname: Fan
authors.forename: Hung-Ming
authors.initials: HM
authors.lastname: Wang
authors.forename: Shu-Hang
authors.initials: SH
authors.lastname: Ng
authors.forename: Chuen
authors.initials: C
authors.lastname: Hsueh
authors.forename: Li-Yu
authors.initials: LY
authors.lastname: Lee
authors.forename: Chih-Hung
authors.initials: CH
authors.lastname: Lin
authors.forename: Tzu-Chen
authors.initials: TC
authors.lastname: Yen
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D009061:Mouth Mucosa; D009062:Mouth Neoplasms / Q000453:epidemiology* / Q000473:pathology; D009362:Neoplasm Metastasis; D011379:Prognosis; D018570:Risk Assessment; D016019:Survival Analysis; D013624:Taiwan; D014062:Tongue Neoplasms / Q000453:epidemiology* / Q000473:pathology; D016896:Treatment Outcome