• Asian Pacific Journal of Cancer Prevention
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• v.15 no.5
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• pp.1971-1975
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• 2014

Background: Tongue cancer is still a major health problem in most developing countries around the world. Statistics shown the number of tongue cancers, especially in early age, to be increasing, with poor survival. Objective: To analyze the characteristic profile of tongue cancer patients in Indonesia as well as the survival rate. Materials and Methods: A cross sectional study was conducted in Dharmais National Cancer Hospital by collecting general, clinical, and survival data of tongue cancer patients from medical records for January 2009 to April 2012. Results: Tongue cancer incidence increased year by year. The average age of tongue cancer patients was 47.5 years, and males predominated, accounting for 64.5% of cases. Most patients presented at an advanced stage (69.6%). The histopathology type was squamous cell carcinoma in the vast majoriy (96.8%). The therapies applied were surgery (45.6%), radiation (63.6%) and chemotherapy (57.6%). The survival rate after one year is 60.6% and after two years was 12.1%. In addition, median survival of tongue cancer patients was 20 months (95% confidence interval 9.07-30.9). The significant factor affecting survival was size of tumor with a hazard ratio of 3.18 (95% CI, 1.02-9.93; p 0.046) for largest versus smallest categories. Conclusions: In each year, the number of tongue cancer incidents in Indonesia is increasing. The age of tongue cancer patients in Indonesia is younger compared to other countries. Moreover, the survival rates are not high.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.4
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• pp.1371-1374
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• 2015

Background: Tongue cancer is one of the leading sites of cancer in our population. Aim: To evaluate the socio-demographic profiles and stages at diagnosis of oral tongue (OT) and base of tongue (BT) cancers, and identify any possible variations in characteristics. Materials and Methods: A retrospective analysis was conducted on tongue cancer cases, divided into OT and BT, registered at the hospital cancer registry of North-East India during January 2010 to May 2013. Cases were analyzed for age, gender, residential status and different levels of education for patients, the stage at diagnosis and presence of distant metastasis. Results: A total of 1,113 cases of tongue cancers were registered, 846(76.1%) of BT and 267(23.9%) of OT. While 33.9% of BT cancer patients were above 65 years of age, the figure for OT cancers was 18.4%, stages III and IV accounting for 90.8% and 77%, respectively. The relative risk for distant metastasis in OT cancers was 3.3 (95% CI 1.08-10.1, p=0.03). Conclusions: In the subsites of tongue cancers in our population, the majority arose from the base of tongue, these tending to occur in older individuals and presenting at late stage.

• Journal of Korean Traditional Oncology
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• v.27 no.1
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• pp.13-23
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• 2022

Objective: The purpose of this review is to analyze the clinical studies on tongue diagnosis in cancer patients. Methods: Domestic and foreign databases were used, such as Pubmed, google scholar, Wanfang med online, Scopus, and OASIS. Searching keywords were tongue diagnosis, tongue color, tongue fur, tongue inspection, cancer, tumor, neoplasm, carcinoma, etc. Studies on tongue diagnosis in cancer patients were included. The published year was limited from 2000 to June 2022. Results: Thirteen studies were enrolled. All selected studies were cross-sectional studies. Cancer patients tend to have a dark and blue-purple tongue, thick fur, yellow fur, fissure tongue, and red dots on the tongue compared with non-cancer patients. With the aggravation of cancer, the rate of patients having dark or blue, or purple tongues increased, and the patients' sublingual veins became wide and tortuous. Conclusion: This study suggests that cancer patients tend to have distinct features of tongue diagnosis. Further researches are warranted.

• THE JOURNAL OF KOREAN ORIENTAL ONCOLOGY
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• v.9 no.1
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• pp.89-97
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• 2003

Recently, the occurrence and death rates of cancer have increased rapidly. In oriental medicine, the tongue gives some kind of special physiological information on human body. Oriental medical doctors have used information about the color, degree of wetness and shape of the patient's tongue to determine patient's disease and body condition. This fact leads us that the tongue image is one of the most important clinical data for helping doctor's decision making. It also has significant meaning to cancer patients related with traditional theory of oriental medicine. In diagnosis and treatment of cancer, tongue diagnosis can give some prognosis and change o cancer. It also detect the sign of early stage cancer, but it cannot diagnose the kind of cancer and/or benign or malignant. Nowadays BioTechnology(BT) has developed rapidly, but there are a lot of limits(economy, accuracy, clinical significance, etc). Tongue diagnosis is very economic and practical way of diagnose and has a lot of possibility of development. The need for doctors and it also helps the development of tongue diagnosis related with cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.189-195
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• 2016

Oral tongue squamous cell carcinoma (OTSCC) is the most common oral cancer subtype with a maximum propensity for regional spread. Our objective was to study if p53 expression might have any correlation with aggressive patterns of invasion within oral tongue cancers as well as with the histologically identified degree of oral tongue dysplasia. p53 immunoexpression was studied using immunohistochemistry in early staged OTSCCs (n=155), oral tongue dysplasias, (n=29) and oral tongue normal specimens (n=10) and evaluated for correlations with histological and clinicopathological parameters. Our study (n=194) showed a pattern of p53 expression increasing with different grades of tongue dysplasia to different grades of invasive OTSCC (p=0.000). Among the OTSCC tumours, positive p53 expression was seen in 43.2% (67/155) and a higher p53 labelling index was significantly associated with increased Bryne's grade of the tumour invasive front (p=0.039) and increased tumour depth (p=0.018). Among the OTSCC patients with tobacco habits, (n=91), a higher p53 labelling index was significantly associated with increased risk of local recurrence (p=0.025) and with lymphovascular space involvement (p=0.014). Evaluation of p53 through varying degrees of dysplasia to oral tongue cancer indicates that p53 expression is linked to aggressive features of oral tongue cancers and tongue precancers entailing a closer monitoring in positive cases. Among the OTSCCs, p53 expression is associated with tumour aggressiveness correlating with increased grading of invasive tumour front and tumour depth.

• Journal of Physiology & Pathology in Korean Medicine
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• v.19 no.5
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• pp.1437-1442
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• 2005

Tongue Diagnosis is the important traditional oriental medical diagnosis method that observes not only the general physiological state but also some kinds of disease. However, manual tongue diagnosis is much influenced by surrounding illumination. Therefore, Digital Tongue Inspection System(DigiTis) is needed for the quantification of objective tongue information, In this research, Tongue images of 98 malignant Neoplasm patients and 34 normal persons were collected by Digital Tongue Inspection System. Statistical analysis of tongue images and patient data indicates that cancer group has more blue-purple components in tongue body(舌質) and yellow components in tongue coating than normal group. Also, there are a lot of rose-pink components in the cancer group of second stage and blue-purple components in the cancer group of third or fourth stage. Our study shows that tongue image is a useful index for distinction between disease and health. Furthermore we need more extended research through the additional sampling and various disease.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.6
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• pp.537-543
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• 2010

Purpose: The objective of this study is to evaluate the survival rate and influencing factors. Patients and Methods: We studied 104 patients who were diagnosed for squamous cell carcinoma of tongue and received curative treatment in oral oncology clinic of National Cancer Center from June 2001 to December 2009. Results: We found the following results. 1. The overall 5-year survival rate of tongue cancer was 67.0% and there was no significant statistical difference between male and female. 2. A lower survival rate was shown in patients under 40 years (42.2%) than over 40 years (75.5%)(P < 0.05). 3. 5-year survival rates of patients with tongue cancer classified by pTNM classification were 87.4% in early stage and 43.3% (P < 0.05). 4. A higher survival rate was seen in patients without cervical lymph node metastasis (82.0% > 44.1%)(P < 0.05). 5. A higher survival rate was seen in patients of tongue cancer with higher differenciation grade (P < 0.05). 6. It is well known that drinking and smoking have great influence on the survival rate of patients of squamous cell carcinoma of tongue. But these was no statistical significance. Conclusion: The overall 5-year survival rate of tongue cancer was 67.0% and it was mostly influenced by factors like age, pTNM stage, cervical lymph node metastasis, differentiation of cancer cell etc.

• Korean Journal of Bronchoesophagology
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• v.3 no.2
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• pp.270-276
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• 1997

The records of 18 patients with squamous cell carcinoma of the tongue and floor of mouth treated surgically were reviewed. Surgical approaches, staging, treatment modalities, recurrence and vital status were evaluated. The distrubutions of involved sites were tongue(9 cases) and mouth floor(9 cases). Patients were treated by surgery primarily, combined chemotherapy and radiation, and by surgical salvage in the failure cases of radiation and chemotherapy. All ipsilateral necks of mouth floor cancer and advanced tongue cancer were treated with neck dissection. Cases of early tongue cancer could be excised with transoral route, and advanced cases needed transmandibular approach. Whereas, majorites of mouth floor cancer needed transmandibular approach, and other cases could be excised transoral and pull-through approaches. In the recontructions, we used primary closure, pectoralis major myocutaneous flap, forearm free flap, fibular osteocutaneous flap and skin graft. One year survival rate was 93% and 2 year survival rate was 60%.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.5061-5065
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• 2013

Background: Oral tongue squamous cell carcinoma (OTSCC) is the most common cancer diagnosed within the oral cavity worldwide. Many studies in India report OTSCC ranking among the top two most common subsites within the oral cavity. India is often labeled the oral cancer capital of the world. The incidence of tongue cancers in the population-based cancer registry (PBCR) of Chennai is showing an increasing trend. A majority of the oral cavity cancers (85%) in our cancer center present in advanced stages (III and IV). In contrast, early tongue cancers (stages I and II) constitute nearly 45% of all OTSCCs. Aim: The aim of this study was to analyze the clinical profile and epidemiological trends in our early stage tongue cancer patients with an emphasis on tobacco and alcohol habits. Materials and Methods: This retrospective analysis was based on a prospectively collected database of 458 consecutive early stage OTSCC in-patients at a tertiary care oncology centre in Chennai between 1995 and 2008. Results: Our study suggests that the earlier trends have clearly changed whereby nearly half of our patients are now never-tobacco users. The findings of the study indicate that a majority of the patients were never alcohol users (86.4%) and nearly half of them were never tobacco users (49.3%), and they had the best survival outcomes. This increasing trend of OTSCC among non-tobacco users is in contrast to our earlier experience of tongue cancer more than five decades ago.The median age of patients in our study was 53.3 years; the male to female ratio was approximately 2:1. The median follow up for the 458 patients was 53 months. Conclusions: Our study importantly as well as interestingly shows a conspicuous absence of association with the traditional risk factors, tobacco and alcohol.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.19
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• pp.8351-8359
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• 2014

Background: Recent epidemiological data have implicated human papilloma virus (HPV) infection in the pathogenesis of head and neck cancers, especially oropharyngeal cancers. Although, HPV has been detected in varied amounts in persons with oral dysplasia, leukoplakias and malignancies, its involvement in oral tongue carcinogenesis remains ambiguous. Materials and Methods: HPV DNA prevalence was assessed by PCR with formalin fixed paraffin embedded sections (n=167) of oral tongue squamous cell carcinoma patients and the physical status of the HPV16 DNA was assessed by qPCR. Immunohistochemistry was conducted for p16 evaluation. Results: We found the HPV prevalence in tongue cancers to be 51.2%, HPV 16 being present in 85.2% of the positive cases. A notable finding was a very poor concordance between HPV 16 DNA and p16 IHC findings (kappa<0.2). Further molecular classification of patients based on HPV16 DNA prevalence and p16 overexpression showed that patients with tumours showing p16 overexpression had increased hazard of death (HR=2.395; p=0.005) and disease recurrence (HR=2.581; p=0.002) irrespective of their HPV 16 DNA status. Conclusions: Our study has brought out several key facets which can potentially redefine our understanding of tongue cancer tumorigenesis. It has emphatically shown p16 overexpression to be a single important prognostic variable in defining a high risk group and depicting a poorer prognosis, thus highlighting the need for its routine assessment in tongue cancers. Another significant finding was a very poor concordance between p16 expression and HPV infection suggesting that p16 expression should possibly not be used as a surrogate marker for HPV infection in tongue cancers. Interestingly, the prognostic significance of p16 overexpression is different from that reported in oropharyngeal cancers. The mechanism of HPV independent p16 over expression in oral tongue cancers is possibly a distinct entity and needs to be further studied.