Clinico-pathological predictive factors in squamous cell carcinoma of the tongue and the floor of the mouth.

2013 
INTRODUCTION: The incidence of oral squamous cell carcinoma (OSCC) comprises about 2% of all malignant neoplasms. Despite improvement in treatment modalities in OSCC the prognosis remains poor. AIM: The aim of this study is to evaluate clinical and histological predictive factors determining the risk of loco-regional recurrence (LRR) and survival of the patients surgically treated for SCC of the tongue and the floor of the mouth (FOM). MATERIALS & METHODS: The study group consisted of 60 patients with primary SCC of the tongue and FOM who underwent surgical treatment without prior therapy. Clinical and histological factors, such as: age, sex of the patients, comorbidities, tumour site, stage, grade, lymph nodes and mandible involvement, margin status, type of neck dissection and adjuvant radiation therapy, influencing LRR and 5-year disease-specific survival (DSS) were analysed. RESULTS: LRR was observed in 26 (43.3%) patients after 9.6 months on average (SD ± 9.47) and DSS reached 53.3% (95%CI: 40.0-66.3). LRR was more frequent in patients with SCC of the base of the tongue (p = 0.024), posterior part of FOM (p = 0.010) and who underwent MRND (p = 0.043). Adverse impact on DSS had advanced stage of the disease (p = 0.048) and tongue cancer (p = 0.045). In multivariate Cox regression analysis SCC of the tongue achieved the status of independent predictor of LRR (p = 0.028) and DSS (p = 0.011). Lymph node involvement was the second independent predictor of LRR (p = 0.008) as well as DSS (p = 0.015). CONCLUSIONS: The analysis of prognostic factors in SCC of tongue and FOM revealed that lymph node involvement was an independent predictor of LRR and DSS. Moreover, higher risk of LRR and death was observed in patients with tongue cancer, especially localised posteriorly.
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