Squamous cell carcinoma of the oral tongue: an analysis of prognostic factors

Aim: To identify the prognostic significance of different factors in patien ts with squamous cell carcinoma of the tongue. Patients and methods: Sevent y-seven patients with carcinoma of the tongue were treated radically at the King Faisal Specialist Hospital and Research Centre between 1980 and 1989, Twenty patients (26%) were treated by resection alone, 11 (14%) with radio therapy alone, and 46 (60%) with combined resection and radiotherapy. Resul ts: forty-seven patients (61%) had T1-2, 28 (36%) T3-4, and two T-x tumours , The regional nodes were clear in 53 (69%) and contained metastases in 24 patients (31%), Thirty patients (39%) developed recurrences, which were loc al in 9, regional in 14, locoregional in 5, and locoregional with metastati c disease in 2, The five and 10-year overall actuarial survival for all pat ients were 65% and 53%, respectively, and the corresponding relapse-free su rvival 56% and 50%. Univariate and multivariate analyses were done of seven variables - age (<40 compared with greater than or equal to 40 Sears), sex , chewing tobacco use, smoking, TNM stage, surgical margins (clear or invad ed), and treatment (resection, radiotherapy, or the combination), On univar iate analysis chewing tobacco (P=0.04), smoking (P=0.01), invaded resection margins (P=0.04), involved regional lymph nodes (P=0.009), T4 tumours, and patients treated with radiotherapy alone (P=0.001) were associated with po or overall survival. Factors associated with shorter relapse-free survival were age >40 (P=0.03), smoking tobacco (P=0.04), invaded resection margins (P=0.01), and smoking (P=0.01), On multivariate analysis, invaded resection margins and smoking (P=0.04)(P=0.02) were associated with shorter overall survival and relapse-free survival (P=0.03) and (P=0.01), while chewing tob acco independently influenced relapse-free survival only (P=0.03). Conclusi on: Invaded resection margins and smoking were the only independent prognos tic factors that affected both overall and relapse-free survival. Those who chewed tobacco were at high risk of locoregional failure.