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Published in: European Archives of Oto-Rhino-Laryngology 8/2021

01-08-2021 | Head and Neck

Prognostic outcomes of treatment naïve oral tongue squamous cell carcinoma (OTSCC): a comprehensive analysis of 14 years

Authors: Muhammad Faisal, Rahim Dhanani, Sami Ullah, Muhammad Abu Bakar, Nabia Irfan, Kashif Iqbal Malik, Asif Loya, Erovic M. Boban, Raza Hussain, Arif Jamshed

Published in: European Archives of Oto-Rhino-Laryngology | Issue 8/2021

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Abstract

Objectives

To analyze the factors predicting survival outcomes in treatment naïve oral tongue squamous cell carcinoma (OTSCC).

Materials and methods

A comprehensive review of 531 oral tongue carcinoma patients treated with upfront surgery followed by adjuvant radiotherapy or chemoradiotherapy was conducted from 2004–2018.

Results

The mean age of presentation was 53 years (11–86) with a male to female ratio of 1.3:1. The associated risk factors were smoking (21%), betel nut (16%), naswar (9%) and alcohol (1%). Most of the cases were either well (45.1%) or moderately (46.2%) differentiated. Surgery was performed in 164 patients alone while 368 were treated with surgery in combination with adjuvant modalities. Overall (OS) and disease free survival (DFS) were 66 and 71%, respectively, with a median follow up of 2.5 years. Cox regression analysis showed nodal positivity, increased depth of invasion (DOI) and higher lymph node ratio (LNR) as significant prognosticators impacting OS and DSS.

Conclusion

Nodal volume, DOI and LNR are the most consistent predictors of poor outcome in OTSCC. Nodal positivity, depth of invasion > 5 mm and lymph node ratio > 0.04 adversely affect OS and DSS.
Literature
1.
go back to reference Marra A, Violati M, Broggio F, Codecà C, Blasi M, Luciani A et al (2019) Long-term disease-free survival in surgically-resected oral tongue cancer: a 10-year retrospective study. Acta Otorhinolaryngol Ital 39(2):84CrossRefPubMedPubMedCentral Marra A, Violati M, Broggio F, Codecà C, Blasi M, Luciani A et al (2019) Long-term disease-free survival in surgically-resected oral tongue cancer: a 10-year retrospective study. Acta Otorhinolaryngol Ital 39(2):84CrossRefPubMedPubMedCentral
2.
go back to reference Patel SC, Carpenter WR, Tyree S, Couch ME, Weissler M, Hackman T et al (2011) Increasing incidence of oral tongue squamous cell carcinoma in young white women, age 18 to 44 years. J Clin Oncol 29(11):1488–1494CrossRefPubMed Patel SC, Carpenter WR, Tyree S, Couch ME, Weissler M, Hackman T et al (2011) Increasing incidence of oral tongue squamous cell carcinoma in young white women, age 18 to 44 years. J Clin Oncol 29(11):1488–1494CrossRefPubMed
3.
go back to reference Ng JH, Iyer NG, Tan MH, Edgren G (2017) Changing epidemiology of oral squamous cell carcinoma of the tongue: a global study. Head Neck 39(2):297–304CrossRefPubMed Ng JH, Iyer NG, Tan MH, Edgren G (2017) Changing epidemiology of oral squamous cell carcinoma of the tongue: a global study. Head Neck 39(2):297–304CrossRefPubMed
4.
go back to reference Bello IO, Soini Y, Salo T (2010) Prognostic evaluation of oral tongue cancer: means, markers and perspectives (II). Oral Oncol 46(9):636–643CrossRefPubMed Bello IO, Soini Y, Salo T (2010) Prognostic evaluation of oral tongue cancer: means, markers and perspectives (II). Oral Oncol 46(9):636–643CrossRefPubMed
5.
go back to reference van Dijk BA, Brands MT, Geurts SM, Merkx MA, Roodenburg JL (2016) Trends in oral cavity cancer incidence, mortality, survival and treatment in the Netherlands. Int J Cancer 139(3):574–583CrossRefPubMed van Dijk BA, Brands MT, Geurts SM, Merkx MA, Roodenburg JL (2016) Trends in oral cavity cancer incidence, mortality, survival and treatment in the Netherlands. Int J Cancer 139(3):574–583CrossRefPubMed
6.
7.
go back to reference Han G, Xu C, Yu D (2018) Mechanisms correlated with chemotherapy resistance in tongue cancers. J Cancer Res Ther 14(1):1CrossRefPubMed Han G, Xu C, Yu D (2018) Mechanisms correlated with chemotherapy resistance in tongue cancers. J Cancer Res Ther 14(1):1CrossRefPubMed
8.
go back to reference Bonnardot L, Bardet E, Steichen O, Cassagnau E, Piot B, Salam AP et al (2011) Prognostic factors for T1–T2 squamous cell carcinomas of the mobile tongue: a retrospective cohort study. Head Neck 33(7):928–934CrossRefPubMed Bonnardot L, Bardet E, Steichen O, Cassagnau E, Piot B, Salam AP et al (2011) Prognostic factors for T1–T2 squamous cell carcinomas of the mobile tongue: a retrospective cohort study. Head Neck 33(7):928–934CrossRefPubMed
9.
go back to reference Cracchiolo JR, Xu B, Migliacci JC, Katabi N, Pfister DG, Lee NY et al (2018) Patterns of recurrence in oral tongue cancer with perineural invasion. Head Neck 40(6):1287–1295CrossRefPubMedPubMedCentral Cracchiolo JR, Xu B, Migliacci JC, Katabi N, Pfister DG, Lee NY et al (2018) Patterns of recurrence in oral tongue cancer with perineural invasion. Head Neck 40(6):1287–1295CrossRefPubMedPubMedCentral
10.
go back to reference Maddox W, Sherlock E, Evans W (1971) Cancer of the tongue: review of thirteen-year experience–1955-1968. Am Surg 37(10):624–650PubMed Maddox W, Sherlock E, Evans W (1971) Cancer of the tongue: review of thirteen-year experience–1955-1968. Am Surg 37(10):624–650PubMed
11.
go back to reference Zelefsky MJ, Harrison LB, Fass DE, Armstrong J, Spiro RH, Shah JP et al (1990) Postoperative radiotherapy for oral cavity cancers: impact of anatomic subsite on treatment outcome. Head Neck 12(6):470–475CrossRefPubMed Zelefsky MJ, Harrison LB, Fass DE, Armstrong J, Spiro RH, Shah JP et al (1990) Postoperative radiotherapy for oral cavity cancers: impact of anatomic subsite on treatment outcome. Head Neck 12(6):470–475CrossRefPubMed
12.
go back to reference D’Cruz AK, Vaish R, Kapre N, Dandekar M, Gupta S, Hawaldar R et al (2015) Elective versus therapeutic neck dissection in node-negative oral cancer. N Engl J Med 373(6):521–529CrossRefPubMed D’Cruz AK, Vaish R, Kapre N, Dandekar M, Gupta S, Hawaldar R et al (2015) Elective versus therapeutic neck dissection in node-negative oral cancer. N Engl J Med 373(6):521–529CrossRefPubMed
13.
go back to reference Gregoire V, Lefebvre JL, Licitra L et al (2010) Squamous cell carcinoma of the head and neck: EHNS-ESMO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 21(Suppl 5):v184–v186CrossRefPubMed Gregoire V, Lefebvre JL, Licitra L et al (2010) Squamous cell carcinoma of the head and neck: EHNS-ESMO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 21(Suppl 5):v184–v186CrossRefPubMed
14.
go back to reference Rusthoven K, Ballonoff A, Raben D et al (2008) Poor prognosis in patients with stage I and II oral tongue squamous cell carcinoma. Cancer 112:345–351CrossRefPubMed Rusthoven K, Ballonoff A, Raben D et al (2008) Poor prognosis in patients with stage I and II oral tongue squamous cell carcinoma. Cancer 112:345–351CrossRefPubMed
26.
go back to reference Kowalski LP, Medina JE (1998) Nodal metastases: predictive factors. Otolaryngol Clin North Am 31:621–637 (PMID: 9687325)CrossRefPubMed Kowalski LP, Medina JE (1998) Nodal metastases: predictive factors. Otolaryngol Clin North Am 31:621–637 (PMID: 9687325)CrossRefPubMed
28.
go back to reference Patel SG, Amit M, Yen TC, Liao CT, Chaturvedi P, Agarwal JP et al (2013) Lymph node density in oral cavity cancer: results of the International Consortium for Outcomes Research. Br J Cancer 109:2087–2095CrossRefPubMedPubMedCentral Patel SG, Amit M, Yen TC, Liao CT, Chaturvedi P, Agarwal JP et al (2013) Lymph node density in oral cavity cancer: results of the International Consortium for Outcomes Research. Br J Cancer 109:2087–2095CrossRefPubMedPubMedCentral
29.
go back to reference Wang YL, Feng SH, Zhu J, Zhu GP, Li DS, Wang Y et al (2013) Impact of lymph node ratio on the survival of patients with hypopharyngeal squamous cell carcinoma: a population-based analysis. PLoS ONE 8:e56613CrossRefPubMedPubMedCentral Wang YL, Feng SH, Zhu J, Zhu GP, Li DS, Wang Y et al (2013) Impact of lymph node ratio on the survival of patients with hypopharyngeal squamous cell carcinoma: a population-based analysis. PLoS ONE 8:e56613CrossRefPubMedPubMedCentral
30.
go back to reference Wang YL, Zhu GP, Li DS, Wang Y, Wang ZY, Ji QH (2013) Lymph node ratio as a survival risk factor for oropharyngeal squamous cell carcinoma patients with lymph node metastasis: a surveillance, epidemiology and end results-based analysis. Head Neck Oncol 5(3):30 Wang YL, Zhu GP, Li DS, Wang Y, Wang ZY, Ji QH (2013) Lymph node ratio as a survival risk factor for oropharyngeal squamous cell carcinoma patients with lymph node metastasis: a surveillance, epidemiology and end results-based analysis. Head Neck Oncol 5(3):30
31.
go back to reference Rudra S, Spiotto MT, Witt ME, Blair EA, Stenson K, Haraf DJ (2014) Lymph node density—prognostic value in head and neck cancer. Head Neck 36:266–272CrossRefPubMed Rudra S, Spiotto MT, Witt ME, Blair EA, Stenson K, Haraf DJ (2014) Lymph node density—prognostic value in head and neck cancer. Head Neck 36:266–272CrossRefPubMed
32.
go back to reference Ong W, Zhao R, Lui B, Tan W, Ebrahimi A, Clark JR et al (2016) Prognostic significance of lymph node density in squamous cell carcinoma of the tongue. Head Neck 38(Suppl. 1):E859–E866CrossRefPubMed Ong W, Zhao R, Lui B, Tan W, Ebrahimi A, Clark JR et al (2016) Prognostic significance of lymph node density in squamous cell carcinoma of the tongue. Head Neck 38(Suppl. 1):E859–E866CrossRefPubMed
33.
go back to reference Prabhu RS, Hanasoge S, Magliocca KR, Hall WA, Chen SA, Higgins KA et al (2015) Lymph node ratio influence on risk of head and neck cancer locoregional recurrence after initial surgical resection: implications for adjuvant therapy. Head Neck 37:777–782CrossRefPubMed Prabhu RS, Hanasoge S, Magliocca KR, Hall WA, Chen SA, Higgins KA et al (2015) Lymph node ratio influence on risk of head and neck cancer locoregional recurrence after initial surgical resection: implications for adjuvant therapy. Head Neck 37:777–782CrossRefPubMed
34.
go back to reference Divi V, Harris J, Harari PM, Cooper JS, McHugh JB, Bell D, et al. Establishing quality indicators for neck dissection: correlating the number of lymph nodes with oncologic outcomes, NRG Oncology/RTOG 9501–0234. J Clin Oncol 2015;33. abstr 6011. Divi V, Harris J, Harari PM, Cooper JS, McHugh JB, Bell D, et al. Establishing quality indicators for neck dissection: correlating the number of lymph nodes with oncologic outcomes, NRG Oncology/RTOG 9501–0234. J Clin Oncol 2015;33. abstr 6011.
35.
go back to reference Ding D, Stokes W, Eguchi M, Hararah M, Sumner W, Amini A, Goddard J, Somerset H, Bradley C, McDermott J, Raben D, Karam SD (2019) Association between lymph node ratio and recurrence and survival outcomes in patients with oral cavity cancer. JAMA Otolaryngol Head Neck Surg 145(1):53–61. https://doi.org/10.1001/jamaoto.2018.2974 (PMID:30452499;PMCID:PMC6439806)CrossRefPubMed Ding D, Stokes W, Eguchi M, Hararah M, Sumner W, Amini A, Goddard J, Somerset H, Bradley C, McDermott J, Raben D, Karam SD (2019) Association between lymph node ratio and recurrence and survival outcomes in patients with oral cavity cancer. JAMA Otolaryngol Head Neck Surg 145(1):53–61. https://​doi.​org/​10.​1001/​jamaoto.​2018.​2974 (PMID:30452499;PMCID:PMC6439806)CrossRefPubMed
Metadata
Title
Prognostic outcomes of treatment naïve oral tongue squamous cell carcinoma (OTSCC): a comprehensive analysis of 14 years
Authors
Muhammad Faisal
Rahim Dhanani
Sami Ullah
Muhammad Abu Bakar
Nabia Irfan
Kashif Iqbal Malik
Asif Loya
Erovic M. Boban
Raza Hussain
Arif Jamshed
Publication date
01-08-2021
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 8/2021
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-020-06482-x

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