title: Functional and survival outcomes in patients undergoing total glossectomy compared with total laryngoglossectomy.
abstract: OBJECTIVE
  To compare functional and survival outcomes for patients undergoing total glossectomy (TG) or total glossectomy plus laryngectomy (TGL) for advanced squamous cell carcinoma (SCC) of the tongue.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Academic tertiary referral center.
  
  
  METHODS
  There were 30 included patients (20 TG, 10 TGL). Outcomes included tumor recurrence, disease-free survival, and functional data (swallowing, gastrostomy tube dependence, speech, airway).
  
  
  RESULTS
  Mean patient age was 56 years with a male predominance (90%). Compared with TG, TGL was more commonly performed for recurrent tumors (90% vs 55%, P = .06). Perineural invasion and extracapsular extension occurred more commonly in the TGL group (80% vs 50%, P = .12). At 12 months postoperatively, 61% of TG patients had disease recurrence compared with 40% of TGL patients (P = .43), and 12-month disease-free survival was 40% (TG) and 50% (TGL). Functionally, more TG patients were totally gastrostomy tube dependent (70% vs 30%, P = .04), and 50% of TG patients were also tracheostomy dependent. Intelligible speech was achieved by 30% of TG and 10% of TGL patients (P = .68).
  
  
  CONCLUSIONS
  Patients undergoing TGL had similar functional and survival outcomes to patients undergoing TG alone despite the presence of more locally advanced disease with greater adverse pathological features. Following TG alone, positive or close margins occurred most commonly at the inferior margin of resection (hyoid/valleculae), which could explain why TGL in patients with advanced tongue SCC may improve local disease control.
authors.affiliation: Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, Alabama 35294-0012, USA.
authors.forename: Catherine F
authors.initials: CF
authors.lastname: Sinclair
authors.forename: William R
authors.initials: WR
authors.lastname: Carroll
authors.forename: Renee A
authors.initials: RA
authors.lastname: Desmond
authors.forename: Eben L
authors.initials: EL
authors.lastname: Rosenthal
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005927:Glossectomy; D006801:Humans; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D019990:Perioperative Care; D011300:Preoperative Care; D015996:Survival Rate; D014062:Tongue Neoplasms / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome