Cervical lymphnode metastasis of early or late T2 tongue carcinoma

Abstract

Between 1986 and 1997, 72 patients (47 males, 25 females) with previously untreated tongue cancer were treated at our institution (surgery: 67, interstitial radiotherapy: 3, palliative therapy: 2). These patients, especially T2 tongue cancer, were classified into two groups (early T2: < or = 3 cm, late T2: > 3 cm) according to the maximum diameter of the primary lesion, and were analyzed for treatment outcome and cervical lymphnode metastasis. (1) The cumulative 5-year survival rates were 65.9% for all cases, 95.0% for T1 cases, 77.5% (94.1% for early T2, 59.7% for late T2) for T2 cases, 24.3% for T3 cases (4-year survival rate), and 0% for T4 cases. (2) The cumulative 5-year survival rates were 90.8% for pN- patients and 21.7% for pN+ patients and the difference was statistically significant (p < 0.05%). In prognosis, pN- patients were better than pN+ patients. Since the N factor was related to the cause of death in 87.5% (7/8) of T2 tongue cancer, control of regional lymph node involvement was the most important prognostic factor. (3) The overall incidence of cervical lymph node metastasis (pN+ or secondary nodal metastasis) was 35.3% for early T2 and 750% for late T2. The control rate of secondary nodal metastasis was 75.0% for early T2 and 33.3% for late T2. Partial glossectomy only (observation for occult lymphnode metastasis) is recommended for treatment of T2N0, whereas glossectomy with selective neck dissection by the pull-through method is recommended for treatment of late T2.