Abstract
In the present retrospective study, a total of 42 patients with tongue cancer who had received their primary treatment at the Department of Otolaryngology Head and Neck Surgery, Tokushima University Hospital, between January 2010 and December 2015 were enrolled. The patients consisted of 24 men and 18 women, with a mean age of 63.7 years (range 30–93 years). The 5-year overall and disease-specific survival rates were 65.7% and 67.7%, respectively. The 5-year overall survival rates according to the disease stage were as follows: stage I, 85.7%; stage II, 85.7%; stage III, 66.6%; stage IVA, 36.1%. The 5-year overall survival rates according to the T stage were as follows: T1, 85.7%; T2, 63.1%; T3, 62.5%; T4, 50.0%. The 5-year overall survival rates according to the N stage were as follows: N0, 86.9%; N1, 50.0%; N2b, 34.0%; N2c, 0%.
Of the 22 (32%) tongue cancer patients with stage I or II disease, 7 developed occult nodal metastasis after the primary surgery. Out of the 9/15 patients with stage II disease who underwent elective neck dissection as part of the primary surgery, 2 developed occult nodal metastasis outside the dissection area; on the other hand, 4 of the 6 patients with stage II disease who did not undergo elective neck dissection developed occult nodal metastasis. These results suggest that elective neck dissection could improve the prognosis of patients with tongue cancer, however, the indications still remain controversial. We developed a new combined index of SUVmax of the lymph nodes in PET/CT by a weighting coefficient plus the minor axis diameter of the LN on CECT, and showed that this combined index might be a promising tool to improve the diagnostic performance of occult nodal metastasis and enable selection of clinical N0 patients with tongue SCC for elective neck dissection.
