title: Total glossectomy with preservation of the larynx: oncological and functional results.
abstract: Our aim was to analyse the overall and disease-free survival (DFS), time to recovery of oral feeding, and morbidity, in a consecutive series of patients who had total glossectomy with preservation of the larynx for advanced cancer of the tongue at the European institute of Oncology (Milan). From June 2002 to April 2011, 37 patients who were treated for advanced cancer of the tongue had total glossectomy, bilateral neck dissection, and preservation of the larynx. Various flaps were used for reconstruction. Overall and disease-free survival were assessed from the day of operation to the latest outpatient examination. Postoperative morbidity and rehabilitation of feeding were also assessed. Six patients had major complications, four of whom had a second operation for necrosis of the flap. Actuarial five-year overall survival (OS) and disease-free survival were 54% and 47%. Twenty-four patients (65%) were operated on as their first treatment, and had 79% five-year overall survival and 61% 5-year disease-free survival. Twenty-six patients were eventually able to feed orally postoperatively. Although this retrospective study include a limited number of patients, the results support the validity of total glossectomy as a safe procedure for advanced cancer of the tongue. Pretreated patient were previously treated with surgery, radiotherapy or chemoradiotherapy with curative purposes. Nevertheless, the long period required for recovery of oral feeding indicates that total glossectomy should be reserved for highly motivated patients.
authors.affiliation: Division of Head and Neck Surgery, European Institute of Oncology, via Ripamonti 435, 20141 Milano, Italy. valeria.navach@ieo.it
authors.forename: Valeria
authors.initials: V
authors.lastname: Navach
authors.forename: Valeria
authors.initials: V
authors.lastname: Zurlo
authors.forename: Luca
authors.initials: L
authors.lastname: Calabrese
authors.forename: Maria Angela
authors.initials: MA
authors.lastname: Massaro
authors.forename: Roberto
authors.initials: R
authors.lastname: Bruschini
authors.forename: Gioacchino
authors.initials: G
authors.lastname: Giugliano
authors.forename: Mohssen
authors.initials: M
authors.lastname: Ansarin
authors.forename: Fausto
authors.initials: F
authors.lastname: Chiesa
mesh_terms: D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D003679:Deglutition / Q000502:physiology; D018572:Disease-Free Survival; D004435:Eating / Q000502:physiology; D005500:Follow-Up Studies; D005927:Glossectomy / Q000379:methods* / Q000534:rehabilitation; D006085:Graft Survival; D006801:Humans; D007830:Larynx / Q000502:physiology; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation; D037981:Neck Dissection / Q000379:methods; D059351:Organ Sparing Treatments; D011183:Postoperative Complications; D018714:Radiotherapy, Adjuvant; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function / Q000502:physiology; D012086:Reoperation; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods; D013065:Speech Intelligibility / Q000502:physiology; D013524:Surgical Flaps; D015996:Survival Rate; D014062:Tongue Neoplasms / Q000601:surgery*; D055815:Young Adult