Cancer of the tongue and oral cavity in Auckland, New Zealand, 1970-86.

Abstract

This report comprises a retrospective review of the clinical data on 157 patients seen in the Auckland area having a diagnosis of cancer of the tongue, floor of the mouth, inferior alveolus, or buccal mucosa (retromolar area, vestibule of the mouth, and cheek mucosa) during 1970-86. One hundred patients were male, 95% were European, 85% were cigarette smokers, and 58% had a history of high alcohol intake. All primary tumours were squamous cell carcinomas, 50% were located in the tongue, 27% in the floor of the mouth, and 11.5% each in the buccal mucosa and inferior alveolus. The majority (60%) of patients with tongue cancer were clinically stage I at presentation while other intra-oral tumours were evenly distributed between stages I and IV. Surgical resection of the primary intra-oral lesion produced local control in 90% of stage I tumours, but this fell to below 70% in stage II-IV tumours. Most patients (82%) who recurred locally had positive or 'close' margins, and this rate of local tumour recurrence as a consequence of narrow margins did not decrease with the addition of adjuvant radiotherapy. Of those patients with stage I disease who received only treatment of the primary lesion, 20% later developed regional nodal disease which was controlled in more than half by neck dissection, but control was achieved only in 11% of patients treated with radiation. The presence of regional disease at presentation was associated with a poor prognosis. It is concluded that local control of inferior oral cavity tumours can be achieved if resection is accomplished with clear margins.(ABSTRACT TRUNCATED AT 250 WORDS)