Is long term follow up mandatory for Stage I oral tongue cancer?

Publication date: Available online 7 July 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Robert A. Ord, Amal Isaiah, Donita Dyalram, Joshua E. Lubek

Abstract

Objective

The objective of this study was to analyze the outcomes and possible risk factors for late recurrence of patients with pathologically Stage I oral tongue squamous cell carcinomas (SCC) considered to be disease free at 3 years.

Materials and Methods

Retrospective study design evaluating all patients with pathologic Stage I oral tongue cancer within a tertiary care center between 2003-2013 followed for a minimum of 36 months.

Results

112 patients met inclusion criteria for long-term analysis. Despite the high OS of 92.2% for true pT1N0M0 disease, a total of 25/112 patients (22.3%) failed initial surgery, developing late disease recurrence (>36 months follow-up) either locally 19.6% (n=22), regionally 4.4% (n=5) or second primary disease 11.6% (n=13). Eleven (50%) of the patients who recurred locally were able to be salvaged with a second surgery, requiring no further treatment (mean 48.7 months). Projected 10-year disease free survival and overall survival was 61 and 89%, respectively. 33% (n=3/9) of deaths occurred in long-term patients considered to be disease free at 36 months.

Conclusion

Stage I tongue SCC is more common in females and is associated with pre-existing leukoplakia. Although overall survival is excellent, a high failure rate either due to local recurrence or a new second primary is seen over an extended time period. Long-term follow-up is mandatory as local salvage rates are excellent if diagnosed early. Regional failure carries a poor prognosis.

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