Surgical treatment of squamous cell carcinoma of the oral tongue: factors influencing survival.

One hundred fifty patients with squamous cell carcinoma of the oral tongue (anterior two thirds) treated initially by surgery alone were analyzed and factors influencing survival were evaluated. Thirteen patients who died without evidence of disease in less than five years were excluded, leaving 137 determinate cases for review. The overall survival was 67.9%. The presence or absence of cervical node metastases appeared to be the most important determining factor in this series. The size of the primary lesion in itself did not play a substantial role in local control. However, overall survival was affected because the larger the primary lesion the higher the incidence of cervical metastases, and therefore, the lower the survival. It is concluded that partial glossectomy is effective treatment for control of localized disease (92.7%). Since cervical node metastases lowered the survival figures to 31%, it appears that more aggressive prophylactic treatment in the form of neck dissection or radiotherapy is indicated for lesions larger than 2 cm.