The purpose of this study was to determine the efficacy of surgical treatment for tongue cancer. We reviewed our experience in the treatment of tongue cancer with surgery as a single definitive treatment modality. METHOD : Two-hundred and seventy-four patients with squamous cell carcinoma of the tongue received all of their treatment at the Division of Head and Neck Surgery of the National Cancer Center Hospital East from July 1992 to June 2000. They were 172 males and 102 females, whose ages ranged from 20 to 93 years (median 59) and the median follow-up period for living patients was 65 months. RESULTS : Clinically, there were 54 patients with Stage I, 125 patients with Stage II, 55 patients with Stage III, and 40 patients with Stage IV. Advanced stage (Stages III and IV) was diagnosed in 35% of patients at presentation. Nodal metastasis was noted in 76 cases (28%) at the first treatment. About 30% patients underwent primary resection surgery with pull-through method and free flap reconstruction. Ninety-five percent of patients received surgical treatment only. The incidence of tumor recurrence was 38%, 47%, 56% and 61% for Stage I, Stage II, Stage III and Stage IV, respectively. Recurrence in the neck lymph node was twice as common as primary site recurrence. Seventy-one percent of recurrences occurred within the first 12 months. The estimated Kaplan-Meier 5-year cause-specific survival rate for all patients was 69%. The 5-year cause-specific survival rates for Stage I, Stage II, Stage III and Stage IV disease were 85%, 75%, 62% and 43%, respectively. CONCLUSION : Significant decrease in cause-specific survival rate was observed in patients with advanced stages, positive clinical node and tumor recurrence. Close monitoring in the first year is recommended because of the high incidence of tumor recurrence.
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