View on the problem of treatment Т1-2N0M0 squamous cell carcinoma of tongue

Halay O.O.1, Bilynskyi B.T.2, Bondarenko S.G.1, Duda O.R. 1, Druzuk O.V.1, Karp S.U.1, Ludchak V.Y.1, Sendega I.M.1, Slipetsky R.R.2, Shmidt M.R.1, Colko T.R.1

Summary. Aim. To consider the reasons of insufficient efficiency of treatment of patients with cancer of language Т1-2N0M0. Materials and methods. We performed a retrospective analysis of 97 patients with Т1–2N0M0 squamous cell carcinoma of the tongue treated in the Department of Head and Neck Tumors in the Lviv Oncology Center. We divided patients to 6 groups depending on the method of treatment. 29 (29.9%) patients had only surgical treatment, in 41 (42.3%) cases — surgery+radiation therapy, in 7 (7.2%) — chemoradiotherapy after surgery. Eight (8.2%) patients had only a course of radiation therapy, in 4 (4.1%) cases — only chemoradiotherapy, and 8 (8.2%) patients refused treatment. 77 patients received surgery, of which 29 (37.7%) underwent selective lymphadenectomy of I–III levels in addition to the removal of the primary tumor. Results. The median survival rate of patients who received treatment was 87 months, and in patients who refused it reached only 5 months (95% CI 4.2–5.7). Five-year survival rate in patients with category T1 was 71.4%, and was significantly better than in patients with cancer of the tongue T2, in which it was 48.8% (χ2=30.1; p=0,00042). Five-year overall survival rate in the subgroup without lymphadenectomy (54.5% [95% CI 47.3–61.7]) was lower than in the subgroup with lymphadenectomy (62.6% [95% CI 53.1–72.1]). If radiation therapy was used before surgery (n=13), the overall survival rate was 20.2±4.9 months, while when exposed to adjuvant radiation (n=28), this rate reached 49.2±7.0 months. Conclusions. In stage I–II of tongue cancer, primary surgical treatment is preferred, which improves the overall 5-year survival rate. Even in the absence of pathological regional lymph nodes (N0) it is advisable to conduct a course of adjuvant radiation therapy.

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