Local Regional Recurrence rates for pT1-2 N0 Oral Tongue Squamous Cell Carcinoma Treated with Surgery Alone at a High Volume Academic Multidisciplinary Head and Neck Oncology Program

Abstract

To report the treatment outcomes of definitive surgery without adjuvant radiation or chemotherapy for patients with pT1-T2 N0 oral tongue squamous cell carcinoma (OTSCC). We conducted a retrospective analysis of patients with pT1-T2N0 (AJCC 7th edition) OTSCC treated at a single academic institution from 2008 to 2018. All patients had definitive surgery at one academic institution with no adjuvant treatment. Two year actuarial rates of local control (LC), regional control (RC), local regional control (LRC), cancer specific survival (CSS), and overall survival (OS) were calculated. Sixty six patients were included in this analysis. The median follow up was 33.9 months (1.2 – 121.8). When using updated staging, 61.5% had pT1 disease, 29.2% had pT2 disease, and 7.7% had pT3 disease (had been pT2 in 7th edition staging). Zero patients had positive margins, 27 had close margins, 1 had positive perineural invasion, 3 had positive LVI, and 18 had DOI > 4mm (13 patients did not have DOI information). Fourteen (14) patients had recurrence: 11 local and 7 regional (4 had both). The 2 year LC, RC, LRC, CSS, and OS were the following: 86%, 95%, 82%, 96%, and 96%. Of the patients with recurrence, 64% (9) were pT1, 21% (3) were pT2, and 14% (2) were pT3. The majority of the patients had elective neck dissection (50 patients, 76%) and specifically 71% of those who recurred had elective neck dissection. No pathological feature was found to be significantly correlated with recurrence. Salvage retreatment was successful for 9 of the 14 recurrences. Recurrence rates after surgery alone for patients with pT1-2N0 OTSCC treated at a high volume academic program are not insignificant (18%), however salvage retreatment is possible. It is reasonable to consider postoperative radiotherapy in patients with pT1-T2N0 OTSCC.