SQUAMOUS-CELL CARCINOMA OF THE TONGUE - EXPERIENCE WITH 86 CONSECUTIVE CASES

Charts from 86 patients treated for carcinoma of the tongue were revie wed to identify strategies that might improve patient outcome. Seventy -one patients (83%) were black and 69 patients (80%) were male. Overal l 2- and 5-year survival rates were 20% and 12%, with stage-specific 2 -year survivals of 71% (I and II, n = 7), 33% (III, n = 15), and 11% ( IV, n = 64) (P < 0.01). Patients with well-differentiated tumors (n = 27) had a higher 2-year survival than that of the others (n = 53, 30% vs. 11%, P = 0.05). Six were unclassified. Twenty-three (27%) patients underwent primary surgical resection and lymphadenectomy with or with out adjuvant therapy. Two-year overall and disease-free survivals were 43% and 26%, respectively. Fifty (58%) patients received radiotherapy with or without chemotherapy, achieving 2-year overall and disease-fr ee survivals of 12% and 6% (P < 0.01). The remaining 13 patients recei ved chemotherapy alone or no treatment and survived an average of 6 mo nths. Distant metastasis were diagnosed in 14 patients (16%). Tongue c arcinoma in this socioeconomic setting was characterized by late diagn osis and poor prognosis. Degree of tumor differentiation, disease stag e, and treatment modality seemed to correlate with prognosis. Surgery, when possible, achieved superior results for disease control and surv ival. While cancer prevention efforts are critical, steps to identify high-risk groups to implement early detection programs may help improv e outcome for these patients. (C) 1993 Wiley-Liss, Inc.