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Cancers Review

June 2014, Volume 1, 1, pp 16-32

Prognostic Factors in Patients with Squamous Cell Carcinoma of the Oral Tongue Treated With Adjuvant Therapy Following Surgery

Valentina Krstevska


Snezhana Smichkoska


Beti Zafirova-Ivanovska

Valentina Krstevska 1
Snezhana Smichkoska 2
Beti Zafirova-Ivanovska 3

  1. Assistant Professor, Head of Department of Head and Neck Cancer, University Clinic of Radiotherapy and Oncology, Skopje, Republic of Macedonia 1

  2. Full Professor, Head of Department of Breast Cancer, University Clinic of Radiotherapy and Oncology, Skopje, Republic of Macedonia 2

  3. Full Professor, Director of the Institute of Epidemiology, Statistics and Informatics, Faculty of Medicine, Skopje, Republic of Macedonia 3

Pages: 16-32

DOI: 10.18488/journal.95/2014.1.1/

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Background. There is limited data on adjuvant treatment following surgery in patients with squamous cell carcinoma of the oral tongue. 
Aims. This retrospective study investigates prognostic value of different factors for local relapse-free survival (LRFS), regional relapse-free survival (RRFS), disease-free survival (DFS), and overall survival (OS) in patients with oral tongue cancer treated with adjuvant therapy following surgery. 
Materials and methods. Forty six patients with surgically treated oral tongue cancer were enrolled in the analysis. Adjuvant therapy consisted of postoperative radiotherapy (PO-RT) or postoperative concurrent chemoradiotherapy (PO-CCRT). All patients received three dimensional conformal radiotherapy. Weekly cisplatin was given as concurrent chemotherapy. Identification of prognostic factors for survival was done with univariate analysis. Multivariate analysis was used for factors confirmed as significant on univariate analysis. 
Results. Independent prognostic factors negatively influencing LRFS, DFS, and OS were ECOG performance status (p = 0.002, p = 0.013 and p = 0.022, respectively), overall stage (p = 0.011, p = 0.010 and p = 0.009, respectively), and pathologic nodal classification (p = 0.016, p = 0.011 and p = 0.015, respectively). Surgical margin status was an independent prognostic factor for RRFS, DFS, and OS (p = 0.032, p = 0.027 and p = 0.028, respectively). The type of adjuvant treatment used was independently prognostic for lower rates of LRFS and DFS (p = 0.029 and p = 0.010, respectively).
Conclusions. Positive postoperative nodal status and close or positive resection margins had the most prominent negative prognostic influence on patients’ survival.  

Contribution/ Originality
This study is one of very few studies which have investigated potential prognostic factors that might influence treatment outcome exclusively in patients with squamous cell carcinoma originating from the oral tongue whose adjuvant therapy following surgery consisted of postoperative radiotherapy or postoperative concurrent chemoradiotherapy. 




  1. K. E. Rusthoven, D. Raben, J. I. Song, M. Kane, T. A. Altoos, and C. Chen, "Survival and patterns of relapse in patients with oral tongue cancer," J Oral Maxillofac Surg., vol. 68, pp. 584-589, 2010.
  2. J. N. Al-Swiahb, C. H. Chen, H. C. Chuang, F. M. Fang, H. T. Tasi, and C. Y. Chien, "Clinical, pathological and molecular determinants in squamous cell carcinoma of the oral cavity," Future Oncol., vol. 6, pp. 837-850, 2010.
  3. S. W. Beenken, H. Krontiras, W. A. Maddox, G. E. Peters, S. Soong, and M. M. Urist, "T1 and T2 squamous cell carcinoma of the oral tongue: Prognostic factors and the role of elective lymph node dissection," Head Neck, vol. 21, pp. 124-130, 1999.
  4. A. P. Yuen, K. Y. Lam, A. C. Chan, W. I. Wei, L. K. Lam, and W. K. Ho, "Clinicopathological analysis of elective neck dissection for N0 neck of early oral tongue carcinoma," Am J Surg., vol. 177, pp. 90-92, 1999.
  5. P. Yuen, C. M. Ho, T. L. Chow, L. C. Tang, W. Y. Cheung, and R. W. Ng, "Prospective randomized study of selective neck dissection versus observation for N0 neck of early tongue carcinoma," Head Neck, vol. 31, pp. 765-772, 2009.
  6. E. N. Myers, Oral cancer overview: The significance of metastasis and surgical management of the neck. Oral cancer metastasis, 1th ed. New York Dordrecht Heidelberg London: Springer, 2010.
  7. J. S. Greenberg, R. Fowler, J. Gomez, V. Mo, D. Roberts, and A. K. El Naggar, "Extent of extracapsular spread: A critical prognosticator in oral tongue cancer," Cancer, vol. 97, pp. 1464-1470, 2003.
  8. J. P. Shah and B. Singh, "Keynote comment: Why the lack of progress for oral cancer?," Lancet Oncol., vol. 7, pp. 356-357, 2006.
  9. J. N. Myers, J. S. Greenberg, V. Mo, and D. Roberts, "Extracapsular spread. A significant predictor of treatment failure in patients with squamous cell carcinoma of the tongue," Cancer, vol. 92, pp. 3030-3036, 2001.
  10. A. S. Hosal, O. F. Unal, and A. Ayhan, "Possible prognostic value of histopathologic parameters in patients with carcinoma of the oral tongue," Eur Arch Otorhinolaryngol, vol. 255, pp. 216-219, 1998.
  11. D. G. Sessions, G. J. Spector, J. Lenox, B. Haughey, C. Chao, and J. Marks, "Analysis of treatment results for oral tongue cancer," Laryngoscope, vol. 112, pp. 616-625, 2002.
  12. K. Hu and L. B. Harrison, Cancer of the oral cavity and oropharynx. Radiation oncology: An evidence based approach, 1th ed. Berlin Heidelberg: Springer-Verlag, 2008.
  13. J. S. Cooper, T. F. Pajak, A. A. Forastiere, J. Jacobs, B. H. Campbell, and S. B. Saxman, "Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck," N Engl J Med., vol. 350, pp. 1937-1944, 2004.
  14. J. Bernier, C. Domenge, M. Ozsahin, K. Matuszewska, J.-L. Lefebvre, and R. H. Greiner, "Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer," N Engl J Med., vol. 350, pp. 1945-1952, 2004.
  15. J. Bernier, J. S. Cooper, T. F. Pajak, M. van Glabbeke, J. Bourhis, and A. Forastiere, "Defining risk levels in locally advanced head and neck cancers: A comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (#22931) and RTOG (# 9501)," Head Neck, vol. 27, pp. 843-850, 2005.
  16. J. S. Cooper, Q. Zhang, T. F. Pajak, A. A. Forastiere, J. Jacobs, and S. B. Saxman, "Long-term follow-up of the RTOG 9501/intergroup phase III trial: Postoperative concurrent radiation therapy and chemotherapy in high-risk squamous cell carcinoma of the head and neck," Int J Radiat Oncol Biol Phys., vol. 84, pp. 1198-1205, 2012.
  17. T.-C. Chen, C.-T. Wang, J.-Y. Ko, P.-J. Lou, T.-L. Yang, and L.-L. Ting, "Postoperative radiotherapy for primary early oral tongue cancer with pathologic N1 neck," Head Neck, vol. 32, pp. 555-561, 2010.
  18. F. L. Greene, D. L. Page, I. D. Fleming, A. Fritz, C. M. Balch, D. G. Haller, and M. Morrow, AJCC cancer staging manual, 6th ed. New York: Springer, 2002.
  19. S. B. Edge, D. R. Byrd, C. C. Compton, A. G. Fritz, F. L. Greene, and A. Trotti, AJCC cancer staging manual, 7th ed. New York Dordrecht Heidelberg London: Springer-Verlag, 2010.
  20. V. Gregoire, A. Eisbruch, M. Hamoir, and P. Levendag, "Proposal for the delineation of the nodal CTV in the node-positive and post-operative neck," Radiother Oncol., vol. 79, pp. 15-20, 2006.
  21. E. L. Kaplan and P. Meier, "Nonparametric estimation for incomplete observation," J Am Stat Assoc., vol. 53, pp. 457-481, 1958.
  22. A. Bessell, A. M. Glenny, S. F. urness, J. E. Clarkson, R. Oliver, and D. I. Con¬way, "Interventions for the treatment of oral and oropha¬ryngeal cancers: Surgical treatment," Cochrane Database Syst Rev. CD006205, vol. 9, 2011.
  23. S.-H. Huang and B. O. Sullivan, "Oral cancer: Current role of radiotherapy and chemotherapy," Med Oral Patol Oral Cir Bucal., vol. 18, pp. 233-240, 2013.
  24. D. P. Goldstein, G. Y. Bachar, J. Lea, M. G. Shrime, and R. S. Patel, "Outcomes of squamous cell cancer of the oral tongue managed at the princess margaret hospital," Head Neck, vol. 35, pp. 632-641, 2013.
  25. S.-K. Tai, W.-Y. Li, P.-Y. Chu, S.-Y. Chang, T.-L. Tsai, and Y.-F. Wang, "Risks and clinical implications of perinerural invasion in T1-2 oral tongue squamous cell carcinoma," Head Neck, vol. 34, pp. 994-1001, 2012.
  26. K.-H. Fan, C.-Y. Lin, C.-J. Kang, H.-M. Huang, E.-Y. Chen, and I.-H. Chen, "Combined-modality treatment for advanced oral tongue squamous cell carcinoma," Int J Radiat Oncol Phys., vol. 67, pp. 453-461, 2007.
  27. Ganly, S. Patel, and J. Shah, "Early stage squamous cell cancer of the oral tongue-clinicopathologic features affecting outcome," Cancer, vol. 118, pp. 101-111, 2012.
  28. Nyman, C. Mercke, and J. Lindstrom, "Prognostic factors for local control and survival of cancer of the oral tongue. A retropective analysis of 230 cases in Western Sweden," Acta Oncol., vol. 32, pp. 667-673, 1993.
  29. S. Chao, B. Emami, R. Akhileswaran, J. Simpson, S. Spector, and D. Sessions, "The impact of surgical margin status and use of an interstitial implant on T1, T2 oral tongue cancers after surgery," Int J Radiat Oncol Biol Phys., vol. 36, pp. 1039-1043, 1996.


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