Relapse patterns and related prognostic factors in patients with mobile tongue cancer treated with postoperative radiotherapy.

PURPOSE: To retrospectively assess prognostic factors and patterns of relapse in patients with oral tongue cancer treated by adjuvant radiotherapy (RT).

PATIENTS AND

METHODS

Between 1995 and 2005, 65 patients with stage II-IV oral tongue cancer were treated with postoperative adjuvant RT at our institution. The influence of multiple patient- and treatment-related factors on local and regional control, and overall survival (OS), locoregional failure- free survival (LRFFS) and cause-specific survival (CSS) were evaluated. Median patient follow-up was 74 months.

RESULTS

Five-year disease-free survival (DFS), LRFFS and CSS rates were 56, 60 and 58%, respectively. During the study period 27 (41.5%) patients had locoregional failures. Seventeen of the recurrences were in the primary tumor region, 4 in the neck, 6 in both regions. Most of the local failures occurred in the first year (median 13 months, range 5-15). Gender, T stage, stage (AJCC TN stage), surgical margin, localization of tumor, and hemoglobin level had predictive value for improved local-regional control in univariate analysis. In total, 35 deaths occurred: 28 patients died of progressive disease, one patient died due to another primary tumor (esophageal cancer) and 6 patients died of other causes.

CONCLUSION

Local failure was the most important problem concerning the final outcome. High local recurrence rates and poor survival rates are important issues in the management of oral tongue cancer. Further strategies should be directed to enhancing cure rates.