Tongue and buccal mucosa carcinoma: is there a difference in outcome?
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.
Liao
Chun-Ta
CT
Department of Otorhinolaryngology, Chang Gung University, Taoyuan, Taiwan, Republic of China. liaoct@adm.cgmh.org.tw
Huang
Shiang-Fu
SF
Chen
I-How
IH
Kang
Chung-Jan
CJ
Lin
Chien-Yu
CY
Fan
Kang-Hsing
KH
Wang
Hung-Ming
HM
Ng
Shu-Hang
SH
Hsueh
Chuen
C
Lee
Li-Yu
LY
Lin
Chih-Hung
CH
Yen
Tzu-Chen
TC
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