Radiat Oncol J.  2019 Jun;37(2):73-81. 10.3857/roj.2018.00577.

Prognostic factors, failure patterns and survival analysis in patients with resectable oral squamous cell carcinoma of the tongue

• Sharma K
• Ahlawat P
• Gairola M
• Tandon S
• Sachdeva N
• Sharief MI

• KMID: 2452567
• DOI: http://doi.org/10.3857/roj.2018.00577

Abstract

PURPOSE
There is sparse literature on treatment outcomes research on resectable oral tongue squamous cell carcinoma (OTSCC). The aim of this study was to measure the treatment outcomes, explore the failure patterns, and identify the potential clinicopathological prognostic factors affecting treatment outcomes for resectable OTSCC.
MATERIALS AND METHODS
It is a retrospective analysis of 202 patients with resectable OTSCC who underwent upfront primary surgical resection followed by adjuvant radiotherapy with or without concurrent chemotherapy if indicated.
RESULTS
The median follow-up was 35.2 months (range, 1.2 to 99.9 months). The median duration of locoregional control (LRC) was 84.9 months (95% confidence interval, 67.3-102.4). The 3- and 5-year LRC rate was 68.5% and 58.3%, respectively. Multivariate analysis showed that increasing pT stage, increasing pN stage, and the presence of extracapsular extension (ECE) were significantly associated with poorer LRC. The median duration of overall survival (OS) was not reached at the time of analysis. The 3- and 5-year OS rate was 70.5% and 66.6%, respectively. Multivariate analysis showed that increasing pT stage and the presence of ECE were significantly associated with a poorer OS.
CONCLUSION
Locoregional failure remains the main cause of treatment failure in resectable OTSCC. There is scope to further improve prognosis considering modest LRC and OS. Pathological T-stage, N-stage, and ECE are strong prognostic factors. Further research is required to confirm whether adjuvant therapy adds to treatment outcomes in cases with lymphovascular invasion, perineural invasion, and depth of invasion, and help clinicians tailoring adjuvant therapy.

Keyword

Head neck; Oral cancer; Tongue; Radiotherapy; Treatment outcome; Prognosis

MeSH Terms

Carcinoma, Squamous Cell*
Drug Therapy
Epithelial Cells*
Follow-Up Studies
Humans
Mouth Neoplasms
Multivariate Analysis
Outcome Assessment (Health Care)
Prognosis
Radiotherapy
Radiotherapy, Adjuvant
Retrospective Studies
Survival Analysis*
Tongue*
Treatment Failure
Treatment Outcome