Summary Management for NO neck patients with tongue cancer

Abstract

A retrospective review of 145 previously untreated patients with squamous cell carcinoma (SCC) of the tongue was performed. All these cases were with no regional and distant metastasis. They were treated in the Kyushu Cancer Center between March 1972 and July 1998, and received interstitial irradiation, an operation, or an operation or interstitial irradiation after arterial infusion chemotherapy via superficial temporal artery combination external irradiation as initial treatment for primary lesion (tongue). The scope of external irradiation included the submandibular nodes and the upper jugular nodes. They did not receive prophyiactic neck dissection except the cases requiring reconstruction of the tongue and floor of the mouth. The five-year survival rate (5YSR) calculated by the Kaplan-Meier method was 82%. Recurrence occurred in 59 patients, of which 21 cases were local, 37 cases were regional and one case was distant recurrence. The 5YSR of local recurrence cases was 61%, that of regional recurrence cases was 56%, and that of distant recurrence cases was 0%. Neck dissection was performed for 35 patients of 37 regional recurrence cases, of which 31 patients were salvaged and 4 patients were uncontrollable. The regional control rate by neck dissection after regional recurrence was 89%. The N stage of the uncontrollable 4 patients was more than N2b. These results suggest that the early detection of regional recurrenceis important.