ABSTRACT
Background: The occult neck metastasis rate is very high with tongue cancers. The aim of this study was to assess the current role of elective neck dissection (END) in management of early-stage oral tongue cancer with a focus on lymph node metastasis. In addition, effects of END on regional or systemic disease recurrence and survival were investigated. Methods: This retrospective study included patients with stage I and II tongue cancer recruited from our National Cancer Institute (NCI) over a time period of six years (2007-2013). The collected data were analyzed for disease free survival (DFS) and recurrence rate. Results: A total of 144 patients presented to our NCI with oral tongue cancer but only 88 were staged clinically and radiologically as early stage (stage I, stage II). Some 53% were smokers. Most lesions were dealt with by surgery, either by wide local excision (22%) or hemiglossectomy (78%). Treatment of neck lesions was either by neck dissection (85.2%) or "wait and see" (14.8%). The rates for local and nodal recurrence were 7.9% and 20.4%, respectively. Analysis of associations between DFS and different factors revealed significance for adoption of adjuvant therapy and the dissected lymph node status. Conclusion: Controversy still exists regarding neck management.
Subject(s)
Carcinoma, Squamous Cell/surgery , Elective Surgical Procedures , Lymph Node Excision , Mouth Neoplasms/surgery , Tongue Neoplasms/surgery , Carcinoma, Squamous Cell/secondary , Disease Management , Female , Follow-Up Studies , Humans , Lymphatic Metastasis , Male , Middle Aged , Mouth Neoplasms/pathology , Neoplasm Staging , Retrospective Studies , Survival Rate , Tongue Neoplasms/secondary , Treatment OutcomeABSTRACT
BACKGROUND: Multiple currently accepted treatments for non melanoma skin cancer (NMSC) are now available. PURPOSE: To present multimodality treatment for NMSCs and to report any side effects or recurrence during three years follow-up period. MATERIAL AND METHODS: This is a prospective study including 120 patients with NMSCs. Patients were subjected to different treatment modalities with follow-up for three years. RESULTS: 103 Patients (85.8%) were treated by surgery with or without post operative radiotherapy, 8 patients (5%) received only radiation therapy, 7 patients (5.8%) treated by shave excision followed by medical treatment (intralesional interferon for 3 months, systemic retinoids and cyclo-oxygenase inhibitor for 6 months), and 2 patients (1.7%) escaped the treatment. All patients treated by shave excision followed by medical treatment showed complete healing of all lesions 6 months after completing the course of treatment. CONCLUSION: Alternatives to the surgical management of NMSC may be preferred under certain circumstances. KEY WORDS: BCC - Interferon - Retinoids - SCC.
