Prognostic Factors and Multidisciplinary Postoperative Chemoradiotherapy for Clinical T4a Tongue Cancer.
OBJECTIVE
The prognosis of patients with locally advanced squamous cell carcinoma (SCC) of the tongue is poor. Postoperative chemoradiotherapy (CRT) improves locoregional control and survival in high-risk patients. We investigated the prognostic factors for clinical T4a tongue SCC, and elucidated whether postoperative CRT has a benefit for patients with poor prognosis in terms of survival.


METHODS
We performed a retrospective analysis of 61 patients with stage T4a SCC of the tongue who underwent primary resection and neck dissection.


RESULTS
The median follow-up was 53.8 months. Multivariate analysis revealed a 4.26× relative risk of death for patients with the involvement of ≥5 regional lymph nodes (pN ≥5) compared with those with pN 0-4 (p = 0.002). In Kaplan-Meier analysis, patients with pN ≥5 who received CRT had longer overall survival rates than those who did not (hazard ratio = 0.31; p = 0.041).


CONCLUSIONS
pN ≥5 is the most powerful prognostic factor for clinical T4a SCC of the tongue. Postoperative CRT is recommended in patients with pN ≥5.
Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan.
Tomoya
T
Yokota
Yoshiyuki
Y
Iida
Hirofumi
H
Ogawa
Tomoyuki
T
Kamijo
Yusuke
Y
Onozawa
Akiko
A
Todaka
Satoshi
S
Hamauchi
Tsuyoshi
T
Onoe
Masahiro
M
Nakagawa
Takashi
T
Yurikusa
Akira
A
Tanuma
Aiko
A
Yamashita
Tetsuo
T
Nishimura
Hirofumi
H
Yasui
Tetsuro
T
Onitsuka
D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000556:secondary* / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009367:Neoplasm Staging; D010094:Oxonic Acid / Q000627:therapeutic use; D010348:Patient Care Team; D011182:Postoperative Care; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate; D005641:Tegafur / Q000627:therapeutic use; D014062:Tongue Neoplasms / Q000473:pathology* / Q000628:therapy*
D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D002945:Cisplatin