Outcome of patients with early T1 and T2 squamous cell carcinoma of the base of tongue managed by conventional surgery with adjuvant postoperative radiation.
BACKGROUND
Existing treatment regimens for squamous cell carcinoma (SCC) of the base of tongue (BOT) favor chemoradiation. However, there is a shifting paradigm toward minimally invasive surgery with adjuvant radiotherapy for select tumors. The aim was to report our experience in conventional surgical management with particular focus on T1/T2 tumors, which may be candidates for minimally invasive techniques.


METHODS
Between 1985 and 2005, 128 patients were treated with primary surgery. Overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) rates were calculated using Kaplan-Meier method, and predictive factors analyzed by univariate and multivariate analyses.


RESULTS
Five-year OS, DSS, and RFS rates were 60%, 70%, and 61%, respectively. Multivariate analysis showed pathologic T classification and extracapsular extension (ECE) were significant predictors for DSS, whereas T classification remained significant for local recurrence. DSS for T1/T2 tumors ranged from 77% (node-positive) to 84% (node-negative).


CONCLUSIONS
T classification and ECE are independent predictors of outcome for BOT SCC. Patients with cT1/T2 tumors had excellent outcome and may be suitable for transoral robotic or endoscopic surgical procedures.
Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
N Gopalakrishna
NG
Iyer
Leslie
L
Kim
Iain J
IJ
Nixon
Frank
F
Palmer
Jatin P
JP
Shah
Snehal G
SG
Patel
Ian
I
Ganly
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011379:Prognosis; D018714:Radiotherapy, Adjuvant / Q000379:methods; D013514:Surgical Procedures, Operative; D015996:Survival Rate; D014062:Tongue Neoplasms / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome