Besides and beyond histopathology; for adjuvant treatment in early tongue cancer

Oral tongue squamous cell carcinomas differ significantly from that of other subsites of oral cavity in relation to clinical behavior. They are more aggressive and have a poorer prognosis. The treatment of choice of early (stage I and II) tongue cancers is surgery. The need for adjuvant treatment is decided on the basis of the histopathology report of the surgical specimen. High-risk patients (positive surgical margins, perineural invasion, lymphovascular spread, lymph node metastasis, and extracapsular extension) receive adjuvant treatment while others are observed. Unfortunately, in the apparently low-risk patients who are observed, there is a high rate of locoregional failure. There are certain histopathology parameters though not routinely validated may be of prognostic significance in this subset of patients. In this review, we have highlighted the importance of the routinely validated and the nonvalidated histopathology parameters and their proper assessment in the decision-making for adjuvant treatment of patients with early tongue cancers.