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01.11.2010 | Head and Neck Oncology | Ausgabe 11/2010

Annals of Surgical Oncology 11/2010

Tongue and Buccal Mucosa Carcinoma: Is There a Difference in Outcome?

Zeitschrift:
Annals of Surgical Oncology > Ausgabe 11/2010
Autoren:
MD Chun-Ta Liao, MD Shiang-Fu Huang, MD I-How Chen, Chung-Jan Kang, MD Chien-Yu Lin, MD Kang-Hsing Fan, MD Hung-Ming Wang, MD Shu-Hang Ng, MD Chuen Hsueh, MD Li-Yu Lee, Chih-Hung Lin, MD, PhD Tzu-Chen Yen

Abstract

Background

We sought to determine the differences in clinical outcome of tongue and buccal carcinomas.

Methods

Five-year locoregional control, distant metastasis, and survival rates were examined in 456 patients with tongue cancer and 407 patients with buccal cancer.

Results

Five-year rates for patients with tongue and buccal carcinomas were as follows: local control, 85% and 87% (P = 0.9366); neck control, 81% and 87% (P = 0.0304); distant metastasis, 8% and 14% (P = 0.0052); disease-free survival, 70% and 72% (P = 0.9978); disease-specific survival, 79% and 78% (P = 0.2435), respectively. After stratification according to pathological lymph node status, patients with buccal cancer and pN0/pNx disease (without neck dissection) had a higher 5-year neck control rate than those with tongue cancer (93% versus 86%, P = 0.0115). In contrast, buccal cancer with pN+ disease had a higher 5-year distant metastasis rate compared with tongue cancer (30% versus 18%, P = 0.0231). In pN0/pNx subjects, neck control was predicted by perineural invasion and the absence of neck dissection in tongue cancer, and by poor differentiation in buccal cancer. In pN+ patients, distant metastases were predicted by pT3–4 disease, age at onset ≤40 years, poor differentiation, and pN+ ≥ 5 nodes in tongue cancer, and by poor differentiation and pN+ ≥ 5 nodes in buccal cancer.

Conclusions

There are significant differences in the failure pattern of tongue and buccal carcinomas. Prognostic models for these malignancies should allow stratification of patients for a risk-adapted approach to treatment.

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