Management of the patients with early stage oral tongue cancers.

The incidence of oral cancer is increasing all over the world and tongue cancer is the most common type of oral cancer. However, standard treatment strategy for early stage tongue cancer has not yet been determined. To assess the appropriate therapy including elective neck dissection, a retrospective chart review of the patients were performed. Thirty-one patients with T1 or T2 tongue carcinomas were surgically treated in our hospital from 2001 through 2005. Twenty-one out of these patients were diagnosed as N0 by physical and diagnostic examinations. Three of 6 patients with T2N0 tumors who had undergone only partial glossectomy had recurrent tumors in the neck and died of disease. The disease-free survival rates at 40 months by Kaplan-Meier analysis were 100% and 60% for T1N0 and T2N0 patients, respectively, with a median follow-up time of 27 months for surviving patients. The depth of the tumor invasion and diameter of the tumors were analyzed. There was a significant difference between the frequency of nodal metastasis in patients with tumor less than 4 mm in depth and patients with tumors more than 4 mm in depth. These data indicate that elective neck dissection should be considered for treating patients with T2N0 tongue cancer because of the poorer prognosis of the patients if they did not undergo elective neck dissection, and that the depth of the tumor invasion is a critical factor for lymph node metastasis and preoperative evaluation of it might be an effective tool for the selection of the therapy.