Prognostic factors in tongue cancer - relative importance of demographic, clinical and histopathological factors

The incidence of and mortality from squamous cell carcinoma (SCC) of the to ngue have increased during the recent decades in the Western world. Much ef fort has been made to predict tumour behaviour, but we still lack specific prognostic indicators. The aim of our study was to evaluate the relative im portance of the known demographic, clinical and histological factors in a h omogeneous population-based group of patients with SCC of the mobile tongue . The demographic and clinical factors were reviewed retrospectively from p rimary and tertiary care patient files. Histological prognostic factors wer e determined from pre-treatment biopsies. The TNM stage was found to be the most important prognostic factor. In particular local spread outside the t ongue rather than spread to regional lymph nodes was related to poor progno sis. Several demographic and histopathological factors were closely related to TNM stage. When the cases were divided into stage I-ii carcinomas and s tage Ill-IV carcinomas, it appeared that the patient's older age (> 65 year s), a high malignancy score and an absence of overexpressed p53 protein wer e associated with a poorer prognosis in stage I-II carcinomas. Such cases m ay require more aggressive treatment. Among patients with stage Ill-IV carc inomas, heavy use of alcohol was significantly associated with a poor disea se-specific survival time. (C) 2000 Cancer Research Campaign.