Tongue Cancer: Is There a Difference in Survival Compared With Other Subsites in the Oral Cavity?

Bell, R. Bryan; Kademani, Deepak; Homer, Louis; Dierks, Eric J.; Potter, Bryce E.

doi:10.1016/j.joms.2005.11.094

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 65, Issue 2 , Pages 229-236, February 2007

Tongue Cancer: Is There a Difference in Survival Compared With Other Subsites in the Oral Cavity?

R. Bryan Bell, DDS, MD
- Attending Surgeon, Oral and Maxillofacial Surgery Service, Legacy Emanuel Hospital and Health Center; Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, Oregon Health and Science University, Portland, OR
- Address correspondence and reprint requests to Dr Bell: 1849 NW Kearney, Ste 300, Portland, OR 97209
Deepak Kademani, DMD, MD
- Assistant Professor of Surgery and Consultant Oral and Maxillofacial Surgeon, Mayo Clinic, Rochester, MN; Former Fellow in Head and Neck Surgery, Legacy Emanuel Hospital and Health Center, Portland, OR
Louis Homer, MD, PhD
- Medical Director of Clinical Investigations and Biomedical Research, Legacy Health Systems, Portland, OR
Eric J. Dierks, DMD, MD
- Fellowship Director and Residency Coordinator, Oral and Maxillofacial Surgery Service, Legacy Emanuel Hospital and Health Center; Clinical Professor, Department of Oral and Maxillofacial Surgery, Oregon Health and Science University, Portland, OR
Bryce E. Potter, DMD, MD
- Chief of Maxillofacial Trauma, Legacy Emanuel Hospital and Health Center; Clinical Professor, Department of Oral and Maxillofacial Surgery, Oregon Health and Science University, Portland, OR

Purpose

Advances in the management of patients with oral squamous cell carcinoma (OSCC) have confounded the importance of site in predicting overall prognosis. The purpose of this retrospective study was to review the outcome of patients with OSCC and to determine if site is a significant predictor of survival or disease-free survival.

Patients and Methods

The records of 233 patients that underwent surgery for resectable OSCC treated at a single institution from 1993 to 2003 were identified. Patients with positive surgical margins, high grade histology, aggressive biologic behavior, or advanced stage disease underwent adjuvant radiotherapy or chemoradiotherapy. The demographics, site, stage, pathologic, treatment, and survival data were collected and statistically analyzed in an attempt to identify predictors of loco-regional control and disease-free survival. Descriptive statistics were calculated for each variable and survival was calculated using the Kaplan-Meier method. For purposes of comparison, patients were divided into 2 groups: those with tongue lesions (n = 73) and all other sites (n = 152). The Cox proportional hazards model was used to distinguish different survival rates between the groups.

Results

Two hundred fifteen patients consisting of 104 males (48%) and 111 females (52%) met the criteria for inclusion in the study. Overall and disease-free survival rates were 56% and 58%, respectively. Stage and grade were identified as having a statistically significant effect on survival (P = .0014, likelihood ratio χ² = 0.04, 1 degree of freedom; and P = .026, χ² = 5, 1 degree of freedom, respectively). There was no significant difference in survival between patients with tongue cancer and other sites in the oral cavity (P = .8, χ² = .04, 1 degree of freedom).

Conclusions

Grade and stage are significant predictors of overall and disease-free survival for patients with OSCC. In this study, however, there was no survival difference between patients with tongue cancer and cancers located at other sites in the oral cavity.