Single Lymph Node Metastasis and Adjuvant Therapy in Stage III Tongue Cancer

Abstract

Background and Objectives We analyzed treatment results among stage III oral tongue squamous cell carcinoma (OTSCC) patients and performed subgroup analyses according to the depth of invasion (DOI) and node positivity.Subjects and Method We retrospectively analyzed the medical records of 87 stage III OTSCC patients.Results A total of 32 recurrences occurred during the study period, eight cases of local recurrence, 12 cases of regional recurrence, eight cases of distant metastasis, and four cases of loco-regional recurrence. During the study period, 27 patients died due to disease progression. The 5-year recurrence-free survival of the patients was 62.9%, and the 5-year disease-specific survival (DSS) was 75.3%. When prognostic factors related to disease recurrence and survival were analyzed through univariate and multivariate analyses, only the N classification was significantly associated with patient survival (hazard ratio 0.36, confidence interval 0.14-0.91). The 5-year DSS of N0 patients was 87.6%, and the 5-year DSS of N1 patients was 63.9%. Among N1 patients, the 5-year DSS was 90.5% when adjuvant therapy was administered and 63.9% when adjuvant therapy was not administered, which is a statistically significant difference. We did not observe any difference in treatment outcome or survival between patients with superficial (DOI ≤10 mm) or deep lesions (DOI >10 mm).Conclusion Among the stage III OTSCC patients, patients with single lymph node (LN) metastasis (N1) showed a distinct prognostic difference from other patients (N0), and the administration of adjuvant therapy to patients having single LN metastasis without other risk factors significantly improved their 5-year DSS.