Oncologic and functional results after transoral laser microsurgery of tongue base carcinoma

Abstract

The objective of the study was to determine the oncological and functional results in patients after excision of tongue base carcinoma by transoral laser microsurgery. A retrospective unicenter study performed between 1986 and 2007. 82 patients with previously untreated squamous cell carcinoma of the tongue base (T1-4, N0-2, M0) underwent transoral laser surgery with curative intent. Stage distribution was as follows: stage I, 1 case (1 %): stage II, 6 cases (7 %): stage III, 14 cases (17 %): stage IV 61 cases (75 %). Main outcome measures are local control rate, overall survival, recurrence-free survival, complications, and feeding tube dependence. The results were Kaplan-Meier 5-year local control rate for all patients was 84 %. T-stage-related local control rate after 5 years was 94 % for stage I-II, 78 % for stage III and 81 % for stage IV. 5-year overall survival and recurrence-free survival were 59 and 69 %, respectively. UICC stage-related overall survival and recurrence-free survival were 70 and 86 % for stage I-II, 44 and 54 % for stage III and 58 and 69 % for stage IV. Postoperative bleeding at the primary tumor site occurred in 9 patients (11 %). Gastrostomy tubes remained in place permanently in 5 patients (6 %). Primary transoral laser microsurgery of tongue base carcinoma offers convincing oncological and functional results comparable to other treatment modalities, e.g., radio(chemo)therapy but has lower rates of morbidity.