Valor prognostico da metastase regional no carcinoma epidermoide de lingua e soalho bucal / Prognostic value of regional metastasis in squamous cell carcinoma of the tongue and floor of mouth

RESUMO

A presença da metástase linfonodal é um fator limitante da sobrevida no câncer da boca. OBJETIVO: Avaliar as causas de falha no tratamento dos carcinomas de língua e soalho de boca em função do estadiamento. MÉTODO: Foram analisados 365 casos de carcinoma epidermoide de boca, tratados de 1978 a 2007, sendo 48 T1, 156 T2, 98 T3 e 63 T4, dos quais 193 foram pNo e 172 pN+. RESULTADOS: Entre os casos pN+, foram observados 17/46 recidivas (36,9%) nos casos não irradiados e 46/126 (36,5%) nos casos irradiados. Quanto aos resgates, nos casos pN0, obtivemos 16/51 (31,3%) e, nos pacientes pN+, de 3/77 (3,9%). CONCLUSÃO: O sucesso dos resgates é menor em pacientes com pN+, com maior recidiva local e menor sobrevida. .

ABSTRACT

The presence of metastatic nodes is a survival-limiting factor for patients with mouth tumors. OBJECTIVE: To evaluate the causes of treatment failure in carcinomas of the tongue and floor of the mouth due to staging. METHOD: This study included 365 patients with squamous cell carcinoma of the mouth treated from 1978 to 2007; 48 were staged as T1, 156 as T2, 98 as T3, and 63 as T4, of which 193 were pNo and 172 pN+. RESULTS: Among the pN+ cases, 17/46 (36.9%) of the patients not treated with radiation therapy had relapsing tumors, against 46/126 (36.5 %) of the patients who underwent radiation therapy. Success rates in the group of subjects submitted to salvage procedures were 16/51 (31.3%) for pN0 patients and 3/77 (3.9%) for pN+ patients. CONCLUSION: Salvage procedure success and survival rates are lower for pN+ patients; pN+ individuals also have more relapsing local disease. .