The results of combined treatment surgery and postoperative radiotherapy for tongue cancer and prognostic factors

Year 2007, Volume: 17 Issue: 1, 1 - 6, 12.01.2007

Ahmet Karadeniz Mert Saynak Züleyha Kadehci Merdan Fayda Görkem Aksu Hümeyra Kocaelli Günter Hafız

Abstract

Objectives: We evaluated the results of surgical treatment and postoperative radiotherapy and prognostic factors in patients with primary tongue carcinoma. Patients and Methods: The study included 60 patients 31 males, 29 females; median age 54 years; range 22 to 82 years who underwent surgery and postoperative radiotherapy for oral tongue cancer. Tumor staging based on the AJCC-1997 criteria was as follows: stage I n=1 , stage II n=21 , stage III n=12 , and stage IVA n=26 . Surgery included hemiglossectomy n=46, 76% , partial n=13, 22% and total n=1, 2% glossectomy. Neck dissection was performed in 47 patients 78% . Radiotherapy dose was generally 6000 cGy/30 fr. The median follow-up was 51 months range 5 to 180 months . Results: The five-year overall and relapse-free survival rates were 50% and 47%, respectively. Survival at five years was 70% for stage I-III, and 20% for stage IVA. Most of the relapses occurred in the first two years after treatment. Recurrences were encountered in 31 patients 52% . The median survival after recurrence was eight months range 1 to 53 months . In multivariate analyses, significant prognostic factors for overall survival and locoregional control were tumor size, stage, N stage, extracapsular lymph node spread, and total duration of radiotherapy. Complications were within acceptable limits. Conclusion: Postoperative radiotherapy should be standard for patients with stage III and IVA tongue cancer.

Keywords

Squamous cell carcinoma, prognosis, radiotherapy, tongue neoplasms

Dil kanserinde kombine tedavi cerrahi ve radyoterapi sonuçlar› ve prognostik faktörler

Abstract

Amaç: Cerrahi ve cerrahi sonrası radyoterapi uygulanan primer dil kanserli hastalarda tedavi sonuçları değerlendirildi ve prognostik faktörler araştırıldı.Hastalar ve Yöntemler: Çalışmaya ameliyat sonrasında radyoterapi uygulanan dil kanserli 60 hasta alındı.Hastaların tümör evresine AJCC-1997 göre dağılımı, evre I n=1 , evre II n=21 , evre III n=12 , evreIVA n=26 şeklindeydi. Cerrahi tedavide 46 hastaya %76 hemiglossektomi, 13 hastaya %22 parsiyel,bir hastaya %2 total glossektomi, 47 hastada %78 boyun diseksiyonu uygulandı. Işın dozu genellikle6000 cGy/30 fr idi. Medyan takip süresi 51 ay dağılım5-180 ay idi.Bulgular: Tedavi sonrası beş yıllık genel ve hastalıksızsağkalım oranları sırasıyla %50 ve %47 idi. Beş yıllıkgenel sağkalım evre I-III’de %70, evre IVA’da %20 bulundu. Yinelemeler çoğunlukla ilk iki yılda görüldü. Toplam 31hastada %52 yineleme görüldü. Yineleme sonrası medyan sağkalım sekiz ay dağılım 1-53 ay idi. Çokdeğişkenli analizde, tümör çapı, evre, N evresi, kapsüler invazyonvarlığı ve toplam radyoterapi süresi yerel-bölgesel kontrolve genel sağkalım için anlamlı prognostik faktörler olarakbelirlendi. Tedaviye bağlı komplikasyonlar kabul edilebilirsınırlar içinde kaldı.Sonuç: Ameliyat sonrası radyoterapi evre III ve IVA dilkanseri olgularında standart olarak uygulanmalıdır

Keywords

Skuamöz hücreli karsinom, prognoz, radyoterapi, dil neoplazileri

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