TREATMENT OUTCOME OF SQUAMOUS-CELL CARCINOMA OF THE ORAL TONGUE

Treatment outcome was retrospectively assessed in 106 patients with sq uamous cell carcinoma of the oral tongue registered in the population- based Manitoba Cancer Registry between January 1979 and December 1992. Twenty-six percent were diagnosed with stage I lesions, while 33%, 16 %, and 24% were stage II, III, and IV, respectively. Most patients wit h stage I and II disease were treated with either surgery alone (57%) or in combination with radiotherapy (29%). Advanced lesions were gener ally treated with radiotherapy alone (37%) or in combination with surg ery (35%). Actuarial survival at 5 years was 44% for all patients, and 64%, 46%, 42%, and 16% for stages I to IV, respectively. Over 90% of the 35 treatment failures occurred within 24 months. The initial sites of recurrence were the neck in 22 patients, the primary site in 16 pa tients, and distant metastases in 5 patients. At the time of death, di sease was present above the clavicles in 62%, and metastases were iden tified in 22%. Locoregional control remains a significant problem in o ral cancer. Elective treatment of the neck, resection of the primary w ith negative surgical margins, and the use of combined modality treatm ent in advanced stages of disease may help reduce treatment failure.