Surgical techniques and outcomes in the treatment of malignant tongue base tumors

Abstract

Introduction Prognosis of patients with malignant tongue base tumors is poor. Survival is low, in spite of different treatment modalities. Most patients seek treatment too late, when their disease has already progressed to stage III or IV. The aim of this investigation was to compare different treatment modalities in patients with malignant tongue base tumors. Material and methods We have analyzed a total of 82 patients (72 men and 6 women) treated at the ENT Clinic, Clinical Center Novi Sad, between 1992 and 2004. The average age of our patients was 59 years. In regard to lifestyle habits, out of 82 patients, 67 were smokers and 57 were alcohol users (16 of the latter were treated alcoholics). The majority (54/82) of patients were both smokers and alcohol users. Results There were 6% of patients (5/82) with stage I disease, 15% of patients (12/82) with stage II, 24% of patients (20/82) with stage III and 55% of patient (45/82) with stage IV disease. Planocellular cancer was diagnosed in 79/82 patients, and the remaining (3/82) had transitional cell carcinoma. Surgical treatment alone was performed in 17 patients, seven were treated with radiation only, and nine only with chemotherapy. Combined surgical and radiation therapy was performed in 28 patients, and 5 were treated with all three. Ten patients were not treated with any therapy. Tongue base resection only was performed in 12 patients, tongue base resection with epiglottectomy in 20, tongue base resection with supraglottic laryngectomy in 13 and tongue base resection with total laryngectomy in 5 patients. In radiation only cases, 25% of patients survived 20 months, whereas in surgery only cases, 25% of patients survived 27 months. Five-year survival after combined surgical and radiation therapy was 35%. Conclusion Development of tongue base carcinoma is strongly associated with alcohol and tobacco consumption. Survival is low, despite various treatment modalities. However, combined therapy is the therapy of choice in cases with tongue base carcinoma.