Abstract
Initial treatment for tongue cancer without metastasis (N0, M0) was clinically evaluated by an indicator of A0 rate (rate of aliving patient without carcinoma) . All of 82 patients were composed of T1N0 (26 cases), T2N0 (46 cases) and T3N0 (10 cases) .
Initial management for the patients was classified into two groups, surgery (S) and radiotherapy (R) . Contents of the surgery (27 cases) were resection of tongue, resection of tongue with radical neck dissection or en bloc operation of tongue, mouth floor and mandible combined with immediate reconstructive surgery. Contents of radiotherapy (55 cases) were 226Ra needle, 192Ir pin or 198Au grain. The results were as follows. 1. On T1N0 cases, S and R showed good control of primary lesion. The A0 rates were 81.8 % and 73.3 % respectively. Frequency of post metastasis to regional lymphonode in S and R was 37.5 % and 35.9% respectively. The main cause of Dc (died of carcinoma) was recurrent cervical metastasis or distant metastasis to the lung. 2. On T2N0 cases, S and R showed similar A0 rates 76.9 % and 72.7 % respectively. However, in the cases where the tumor size was larger than 3cm, the A0 rate of S (87.5 %) was higher than that of R (57.1 %) . And recurrence rate of primary lesion in the S group was 0 %, while, that in the R group was 37.5 %. On T3N0 cases, A0 rates of S and R were 66.7 % and 28.6 % respectively. In the R group, five out of seven cases (71.4 %) showed post metastasis to regional lymphonode. 4. As an initial management for T2N0 cases where the tumor size is larger than 3cm or for T3N0 cases, en bloc surgical resection showed higher A0 rates than that of radiotherapy
