DOI QR코드

DOI QR Code

Treatment outcomes and prognostic factors in oral tongue cancer: a 20-year retrospective study at the National Cancer Center, South Korea

  • Kim, Min-Gyeong (Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center) ;
  • Choi, Yong-Seok (Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center) ;
  • Youn, Suk Min (Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center) ;
  • Ko, Jae-Hee (Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center) ;
  • Oh, Hyun Jun (Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center) ;
  • Lee, Jong-Ho (Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center) ;
  • Park, Joo-Yong (Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center) ;
  • Choi, Sung-Weon (Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center)
  • Received : 2022.04.02
  • Accepted : 2022.06.07
  • Published : 2022.08.31

Abstract

Objectives: This study aimed to analyze the treatment outcomes and to evaluate the clinicopathological prognostic factors of oral tongue cancer. Patients and Methods: We retrospectively analyzed treatment results and prognostic factors in 205 patients with oral tongue squamous cell carcinoma who were admitted to the National Cancer Center, South Korea, between January 2001 and December 2020. The patients were treated with surgery and postoperative, definitive radiotherapy (RT) or chemoradiotherapy (CRT). Results: Eighteen patients (8.8%) were treated with curative RT or CRT, while the rest (91.2%) were treated with surgery with or without postoperative RT or CRT. The median follow-up period was 30 months (range, 0-234 months). The 5-year overall survival (OS) and 5-year disease-free survival (DFS) were 72% and 63%, respectively. Multivariate analysis revealed that a positive neck nodal status (N1, N2-3) was significantly associated with poorer 5-year OS and DFS, while perineural invasion was associated with poorer 5-year DFS. Conclusion: Cervical metastasis and perineural invasion are significant prognostic predictors, and combination treatments are necessary for improving OS and DFS in patients with these factors.

Keywords

References

  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68:394-424. https://doi.org/10.3322/caac.21492
  2. Shah JP, Gil Z. Current concepts in management of oral cancer--surgery. Oral Oncol 2009;45:394-401. https://doi.org/10.1016/j.oraloncology.2008.05.017
  3. Pulte D, Brenner H. Changes in survival in head and neck cancers in the late 20th and early 21st century: a period analysis. Oncologist 2010;15:994-1001. https://doi.org/10.1634/theoncologist.2009-0289
  4. Zanoni DK, Montero PH, Migliacci JC, Shah JP, Wong RJ, Ganly I, et al. Survival outcomes after treatment of cancer of the oral cavity (1985-2015). Oral Oncol 2019;90:115-21. https://doi.org/10.1016/j.oraloncology.2019.02.001
  5. Choi SW, Moon EK, Park JY, Jung KW, Oh CM, Kong HJ, et al. Trends in the incidence of and survival rates for oral cavity cancer in the Korean population. Oral Dis 2014;20:773-9. https://doi.org/10.1111/odi.12251
  6. Bello IO, Soini Y, Salo T. Prognostic evaluation of oral tongue cancer: means, markers and perspectives (II). Oral Oncol 2010;46:636-43. https://doi.org/10.1016/j.oraloncology.2010.06.008
  7. van Dijk BA, Brands MT, Geurts SM, Merkx MA, Roodenburg JL. Trends in oral cavity cancer incidence, mortality, survival and treatment in the Netherlands. Int J Cancer 2016;139:574-83. https://doi.org/10.1002/ijc.30107
  8. Faisal M, Dhanani R, Ullah S, Bakar MA, Irfan N, Malik KI, et al. Prognostic outcomes of treatment naive oral tongue squamous cell carcinoma (OTSCC): a comprehensive analysis of 14 years. Eur Arch Otorhinolaryngol 2021;278:3045-53. https://doi.org/10.1007/s00405-020-06482-x
  9. Marra A, Violati M, Broggio F, Codeca C, Blasi M, Luciani A, et al. Long-term disease-free survival in surgically-resected oral tongue cancer: a 10-year retrospective study. Acta Otorhinolaryngol Ital 2019;39:84-91. https://doi.org/10.14639/0392-100X-2336
  10. Han G, Xu C, Yu D. Mechanisms correlated with chemotherapy resistance in tongue cancers. J Cancer Res Ther 2018;14:1-5. https://doi.org/10.4103/jcrt.JCRT_763_17
  11. Rusthoven K, Ballonoff A, Raben D, Chen C. Poor prognosis in patients with stage I and II oral tongue squamous cell carcinoma. Cancer 2008;112:345-51. https://doi.org/10.1002/cncr.23183
  12. Cheng YJ, Tsai MH, Chiang CJ, Tsai ST, Liu TW, Lou PJ, et al. Adjuvant radiotherapy after curative surgery for oral cavity squamous cell carcinoma and treatment effect of timing and duration on outcome - a Taiwan Cancer Registry national database analysis. Cancer Med 2018;7:3073-83. https://doi.org/10.1002/cam4.1611
  13. Asakage T, Yokose T, Mukai K, Tsugane S, Tsubono Y, Asai M, et al. Tumor thickness predicts cervical metastasis in patients with stage I/II carcinoma of the tongue. Cancer 1998;82:1443-8. https://doi.org/10.1002/(sici)1097-0142(19980415)82:8<1443::aidcncr2>3.0.co;2-a
  14. Po Wing Yuen A, Lam KY, Lam LK, Ho CM, Wong A, Chow TL, et al. Prognostic factors of clinically stage I and II oral tongue carcinoma - a comparative study of stage, thickness, shape, growth pattern, invasive front malignancy grading, Martinez-Gimeno score, and pathologic features. Head Neck 2002;24:513-20. https://doi.org/10.1002/hed.10094
  15. Huang SH, Hwang D, Lockwood G, Goldstein DP, O'Sullivan B. Predictive value of tumor thickness for cervical lymph-node involvement in squamous cell carcinoma of the oral cavity: a meta-analysis of reported studies. Cancer 2009;115:1489-97. https://doi.org/10.1002/cncr.24161
  16. Inoue M, Nagata C, Tsuji I, Sugawara Y, Wakai K, Tamakoshi A, et al.; Research Group for the Development and Evaluation of Cancer Prevention Strategies in Japan. Impact of alcohol intake on total mortality and mortality from major causes in Japan: a pooled analysis of six large-scale cohort studies. J Epidemiol Community Health 2012;66:448-56. https://doi.org/10.1136/jech.2010.121830
  17. Faisal M, Abu Bakar M, Sarwar A, Adeel M, Batool F, Malik KI, et al. Depth of invasion (DOI) as a predictor of cervical nodal metastasis and local recurrence in early stage squamous cell carcinoma of oral tongue (ESSCOT). PLoS One 2018;13:e0202632. https://doi.org/10.1371/journal.pone.0202632
  18. Montoro JRMC, Hicz HA, de Souza L, Livingstone D, Melo DH, Tiveron RC, et al. Prognostic factors in squamous cell carcinoma of the oral cavity. Braz J Otorhinolaryngol 2008;74:861-6. https://doi.org/10.1016/S1808-8694(15)30146-4
  19. Dolens EDS, Dourado MR, Almangush A, Salo TA, Gurgel Rocha CA, da Silva SD, et al. The impact of histopathological features on the prognosis of oral squamous cell carcinoma: a comprehensive review and meta-analysis. Front Oncol 2021;11:784924. https://doi.org/10.3389/fonc.2021.784924
  20. Sharma K, Ahlawat P, Gairola M, Tandon S, Sachdeva N, Sharief MI. Prognostic factors, failure patterns and survival analysis in patients with resectable oral squamous cell carcinoma of the tongue. Radiat Oncol J 2019;37:73-81. https://doi.org/10.3857/roj.2018.00577
  21. Thiagarajan S, Nair S, Nair D, Chaturvedi P, Kane SV, Agarwal JP, et al. Predictors of prognosis for squamous cell carcinoma of oral tongue. J Surg Oncol 2014;109:639-44. https://doi.org/10.1002/jso.23583
  22. Fagan JJ, Collins B, Barnes L, D'Amico F, Myers EN, Johnson JT. Perineural invasion in squamous cell carcinoma of the head and neck. Arch Otolaryngol Head Neck Surg 1998;124:637-40. https://doi.org/10.1001/archotol.124.6.637
  23. Hilly O, Shkedy Y, Hod R, Soudry E, Mizrachi A, Hamzany Y, et al. Carcinoma of the oral tongue in patients younger than 30 years: comparison with patients older than 60 years. Oral Oncol 2013;49:987-90. https://doi.org/10.1016/j.oraloncology.2013.07.005
  24. Zhang YY, Wang DC, Su JZ, Jia LF, Peng X, Yu GY. Clinicopathological characteristics and outcomes of squamous cell carcinoma of the tongue in different age groups. Head Neck 2017;39:2276-82. https://doi.org/10.1002/hed.24898
  25. Jeon JH, Kim MG, Park JY, Lee JH, Kim MJ, Myoung H, et al. Analysis of the outcome of young age tongue squamous cell carcinoma. Maxillofac Plast Reconstr Surg 2017;39:41. https://doi.org/10.1186/s40902-017-0139-8
  26. Cadoni G, Giraldi L, Petrelli L, Pandolfini M, Giuliani M, Paludetti G, et al. Prognostic factors in head and neck cancer: a 10-year retrospective analysis in a single-institution in Italy. Acta Otorhinolaryngol Ital 2017;37:458-66. https://doi.org/10.14639/0392-100X-1246
  27. Molteni G, Valerini S, Alicandri-Ciufelli M, Sprio AE, Crosetti E, Berta GN, et al. Unravelling the risk factors that underlie oral and oropharyngeal surgery in elderly. Acta Otorhinolaryngol Ital 2018;38:409-16. https://doi.org/10.14639/0392-100X-1507
  28. Listl S, Jansen L, Stenzinger A, Freier K, Emrich K, Holleczek B, et al.; GEKID Cancer Survival Working Group. Survival of patients with oral cavity cancer in Germany. PLoS One 2013;8:e53415. https://doi.org/10.1371/journal.pone.0053415
  29. Funk GF, Karnell LH, Robinson RA, Zhen WK, Trask DK, Hoffman HT. Presentation, treatment, and outcome of oral cavity cancer: a National Cancer Data Base report. Head Neck 2002;24:165-80. https://doi.org/10.1002/hed.10004
  30. Garavello W, Spreafico R, Somigliana E, Gaini L, Pignataro L, Gaini RM. Prognostic influence of gender in patients with oral tongue cancer. Otolaryngol Head Neck Surg 2008;138:768-71. https://doi.org/10.1016/j.otohns.2008.02.026
  31. Leoncini E, Vukovic V, Cadoni G, Pastorino R, Arzani D, Bosetti C, et al. Clinical features and prognostic factors in patients with head and neck cancer: results from a multicentric study. Cancer Epidemiol 2015;39:367-74. https://doi.org/10.1016/j.canep.2015.02.004
  32. Li Y, Mao Y, Zhang Y, Cai S, Chen G, Ding Y, et al. Alcohol drinking and upper aerodigestive tract cancer mortality: a systematic review and meta-analysis. Oral Oncol 2014;50:269-75. https://doi.org/10.1016/j.oraloncology.2013.12.015
  33. Koo K, Barrowman R, McCullough M, Iseli T, Wiesenfeld D. Non-smoking non-drinking elderly females: a clinically distinct subgroup of oral squamous cell carcinoma patients. Int J Oral Maxillofac Surg 2013;42:929-33. https://doi.org/10.1016/j.ijom.2013.04.010
  34. Loeffelbein D, Ritschl LM, Gull FD, Roth M, Wolff KD, Mucke T. Influence of possible predictor variables on the outcome of primary oral squamous cell carcinoma: a retrospective study of 392 consecutive cases at a single centre. Int J Oral Maxillofac Surg 2017;46:413-21. https://doi.org/10.1016/j.ijom.2016.11.014
  35. Sparano A, Weinstein G, Chalian A, Yodul M, Weber R. Multivariate predictors of occult neck metastasis in early oral tongue cancer. Otolaryngol Head Neck Surg 2004;131:472-6. https://doi.org/10.1016/j.otohns.2004.04.008
  36. Jones HB, Sykes A, Bayman N, Sloan P, Swindell R, Patel M, et al. The impact of lymphovascular invasion on survival in oral carcinoma. Oral Oncol 2009;45:10-5. https://doi.org/10.1016/j.oraloncology.2008.03.009
  37. Shim SJ, Cha J, Koom WS, Kim GE, Lee CG, Choi EC, et al. Clinical outcomes for T1-2N0-1 oral tongue cancer patients underwent surgery with and without postoperative radiotherapy. Radiat Oncol 2010;5:43. https://doi.org/10.1186/1748-717X-5-43
  38. Gregoire V, Lefebvre JL, Licitra L, Felip E; EHNS-ESMO-ESTRO Guidelines Working Group. Squamous cell carcinoma of the head and neck: EHNS-ESMO-ESTRO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2010;21 Suppl 5:v184-6. https://doi.org/10.1093/annonc/mdq185