Outcomes for Total Glossectomy vs Laryngoglossectomy

Abstract

Objective: Compare functional and survival outcomes for patients undergoing total glossectomy (TG) or total glossectomy plus laryngopharyngectomy (TGLP) for advanced squamous cell carcinoma (SCC) of the tongue. Method: A retrospective review was undertaken of all patients undergoing TG or TGLP at an academic tertiary referral center between 2002 and 2010. There were 30 included patients (20 TG, 10 TGLP). Outcomes included tumor recurrence, disease-free survival and functional data (swallowing, gastrostomy tube dependence, speech, airway). Results: Mean patient age was 56 years with a male predominance (90%). Compared with TG, TGLP was more commonly performed for recurrent tumors ( P = .06). Perineural invasion and extracapsular extension occurred more commonly for TGLP patients (80% vs 50%, P = .12). There was a trend toward increased tumor recurrence in the TG group (61% vs 40%, P = .43). Twelve month disease free survival was 40% (TG) vs 50% (TGLP). Functionally, more TG patients were totally gastrostomy tube dependent (70% vs 30%, P = .04), and 50% of TG patients were also tracheostomy dependent. Intelligible speech was achieved by 30% TG and 10% TGLP patients ( P = .68). Conclusion: Patients undergoing TGLP had similar functional and survival outcomes to patients undergoing TG despite more locally advanced disease with greater adverse pathological features. Positive or close margins for TG occurred most commonly at the inferior resection margin which could explain why TGLP for advanced tongue SCC may improve local disease control.