Radical surgery for lingual cancer.

The survival rates of 58 patients treated for squamous carcinoma of the tongue between 1972 and 1985 were evaluated. The overall 5-year survival rate was 41.6%; for stage I it was 61.8%; stage II 59.5%; and stage III, 27.7%. No patient survived for more than 2 years when their tumour was stage IV on presentation. A composite pull-through resection with radical neck dissection gave a 5-year survival rate of 50.7%, which was significantly (P less than 0.01) higher than the 13.8% achieved by other treatments, mainly local tumour excision combined with radiation therapy. The same trend in favour of radical surgery was also seen stage by stage. In 45% of the patients regional neck metastases (palpable in 35% and occult in 10%) were present and predicted a poor prognosis. Among T1-T2 cases the 5-year survival of 58.5% in the N0 group was significantly (P less than 0.01) higher than the 15.1% among those with nodal involvement. The location of the primary tumour did not affect the survival rates.