Treatment of base of tongue cancer, stage III and stage IV with primary surgery: survival and functional outcomes

• Published in: European archives of oto-rhino-laryngology Vol. 272; no. 8; pp. 2027 - 2033
• Main Authors: Al-Qahtani, Khaled, Rieger, Jen, Harris, Jeffery R., Mlynarek, Alex, Williams, David, Islam, Tahera, Seikaly, Hadi
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2015
• Subjects: Canada; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Chemoradiotherapy - methods; Combined Modality Therapy - methods; Deglutition; Female; Head and Neck; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - surgery; Head and Neck Surgery; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Staging; Neurosurgery; Otorhinolaryngologic Surgical Procedures - adverse effects; Otorhinolaryngologic Surgical Procedures - methods; Otorhinolaryngologic Surgical Procedures - rehabilitation; Otorhinolaryngology; Postoperative Period; Recovery of Function; Retrospective Studies; Speech; Survival Analysis; Tongue - pathology; Tongue - surgery; Tongue Neoplasms - pathology; Tongue Neoplasms - surgery; Treatment Outcome; Micro vascular reconstruction; Base of tongue; Head and neck cancer; Speech; Oropharynx; Swallowing; Local control and disease-specific survival
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-014-3140-1

This study examines functional outcome (speech and swallowing), survival, and disease control in patients receiving an intensified treatment regimen with primary aggressive surgery, and postoperative radiotherapy or postoperative concomitant chemoradiotherapy, for previously untreated, resectable, stage III and IV squamous cell carcinoma (SCC) of the tongue base. Sixty-six consecutive patients treated from June 1997 to June 2006 were followed prospectively through the Multidisciplinary Head and Neck Surgery Reconstruction Clinic. Speech and swallowing data were gathered at four evaluation times during the first year. Speech assessment was conducted by PERCI, Nasometer, and C-AIDS and swallowing assessment by Modified barium swallow, Diet survey and G-tube. Also, the overall survival, disease-specific survival and loco regional control were measured. The average age of the patients was 56.8, 85 % male and 15 % female. All patients had primary surgical resection and 83 % received postoperative radiotherapy and 17 % chemoradiation therapy. Overall survival at 3 years was 80.3 % and 5 years 52.2 %. Disease-specific survival at 3 years was 86.7 % and 5 years was 77.5 %. Local control was 94 %. Distal metastasis and second primary were found to be 7.5 % each. Primary surgical treatment of advanced BOT cancer offers excellent functional outcome, local control and disease-specific survival.