title: Early stage squamous cell cancer of the oral tongue--clinicopathologic features affecting outcome.
abstract: BACKGROUND
  The objective of this study was to report the authors' experience in the management of patients with early stage squamous cell cancer (SCC) of the oral tongue and determine clinicopathologic factors predictive of outcome.
  
  
  METHODS
  Two hundred sixteen patients with early stage (cT1T2N0) SCC of the oral tongue were identified from a pre-existing database of patients with oral cancer who were treated at Memorial Sloan-Kettering Cancer Center from 1985 to 2005. Patient, tumor, and treatment characteristics were recorded. Overall survival (OS), disease-specific survival (DSS), and recurrence free survival (RFS) were calculated using the Kaplan-Meier method. Predictors of outcome were identified using multivariate analysis.
  
  
  RESULTS
  With a median follow-up of 80 months (range, 1-186 months), the 5-year DSS, OS, and RFS rates were 86%, 79%,and 70%, respectively. Local, neck, and distant recurrences occurred in 24 patients (11%), 40 patients (18%), and 5 patients (2%), respectively. Multivariate analysis identified occult neck metastases as the main independent predictor of OS, DSS, and RFS; patients who had occult metastases had a 5-fold increased risk of dying of disease compared with patients who did not have occult metastases (5-year DSS, 85.5% vs 48.5%; P = .001). A positive surgical margin was the main independent predictor for local RFS (91% vs 66% for a negative surgical margin; P = .0004), and depth of invasion was the main predictor for neck RFS (91% vs 73% for depth of invasion <2 mm and >2 mm, respectively; P = .02).
  
  
  CONCLUSIONS
  In the authors' experience, patients with early stage oral tongue cancer have excellent outcomes. In the current study, the presence of occult metastases was the main predictor of survival outcome.
authors: Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA. ganlyi@mskcc.org
authors: Ian
authors: I
authors: Ganly
authors: Snehal
authors: S
authors: Patel
authors: Jatin
authors: J
authors: Shah
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D018307:Neoplasms, Squamous Cell / Q000175:diagnosis* / Q000401:mortality* / Q000473:pathology*; D011379:Prognosis; D014062:Tongue Neoplasms / Q000473:pathology