Early oral tongue cancer initially managed with surgery alone: Treatment of recurrence

Abstract

Objective: To report T1-2N0 tongue cancer recurrences initially treated with surgery alone. Methods: Between 1990 and 2010, 27 patients at tertiary hospital referral center institution were treated with curative intent for locoregional recurrence after initial glossectomy with or without neck dissection for T1-2N0 tongue cancer. None had received adjuvant postoperative radiation as a component of the original treatment. Results: Median time to locoregional recurrence was 12 months (range 5–39 months) and 78% of failures occurred in the first 2 years. Most treatment failures were local (63%). Salvage strategy was risk-adapted by individual patient. The 5-year disease specific survival (DSS) was 61%. Patients with local recurrences alone fared significantly better than those with regional recurrences (5-yr DSS: 86% vs. 22%, P = 0.0018). Local recurrences were usually treated by surgery alone, while regional recurrences were more commonly treated with combined modality treatment (P = 0.005). Conclusions: Recurrence of early stage oral tongue cancer can be successfully salvaged in a majority of cases. Patients developing regional recurrence have significantly worse prognosis than those with local failures. Keywords: Oral cancer, Head and neck cancer, Tongue neoplasms, Salvage therapy