title: Prognostic significance of hyoid bone invasion in advanced base of tongue carcinoma treated by chemoradiation.
abstract: OBJECTIVE
  To examine the prognostic influence of hyoid bone invasion in advanced base of tongue squamous cell carcinoma treated with chemoradiation.
  
  
  METHODS
  We retrospectively reviewed pre-treatment imaging (CT/MRI) for the presence or absence of hyoid bone invasion in patients with advanced (clinical T3 or T4a stage) base of tongue squamous cell carcinoma treated with chemoradiation from January 2001 to January 2011. We compared patients with hyoid bone invasion to those without based on the following metrics: 1-, 2- and 5-year locoregional recurrence-free survival, disease-free survival, disease-specific survival and overall survival.
  
  
  RESULTS
  Eleven of thirty-seven patients had hyoid invasion present on pre-treatment imaging. Average follow-up was 45 months. Patients with hyoid bone invasion were found to have lower percentages in all survival metrics measured compared to patients without, respectively, with statistical significance achieved in the following: 2-year locoregional recurrence-free survival: 36.4% versus 86.4% (P = 0.006), 5-year locoregional recurrence-free survival: 12.5% versus 63.6% (P = 0.05), 2-year disease-free survival: 36.4% versus 77.3% (P = 0.05), 5-year disease-free survival: 12.5% versus 63.3% (P = 0.05) and the Kaplan-Meier curve for locoregional recurrence-free survival (P = 0.0075).
  
  
  CONCLUSIONS
  Hyoid bone invasion by base of tongue squamous cell carcinoma may indicate a poorer prognosis despite treatment. Hyoid bone invasion may be a possible indication for intensification of treatment and/or may indicate a necessity for increasing the degree of post-treatment surveillance monitoring and imaging.
authors: Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, CA, USA.
authors: C M
authors: CM
authors: Heaton
authors: School of Medicine, Graduate Program for Clinical Research, University of California - San Francisco, San Francisco, CA, USA.
authors: F
authors: F
authors: Al-Shwaiheen
authors: Division of Neuroradiology, Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, CA, USA.
authors: C-S J
authors: CS
authors: Liu
authors: Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, CA, USA.|Department of Radiation Oncology, University of California - San Francisco, San Francisco, CA, USA.
authors: S S
authors: SS
authors: Yom
authors: Division of Head and Neck Oncologic/Endocrine/Salivary Surgery, Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, CA, USA.
authors: W R
authors: WR
authors: Ryan
mesh_terms: D002140:California / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006928:Hyoid Bone / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014062:Tongue Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*