Carcinoma of the tongue: A case series analysis of clinical presentation, risk factors, staging, and outcome

Objective. Oral cancer is primarily a disease of epithelial origin. The tongue is the most common site of oral cancer. Oropharyngeal cancer accounts for approximately 2% of all cancer deaths. The purpose of this study was to analyze a case series of patients with tongue cancer. Study design. The medical records of 322 consecutive patients diagnosed with squamous cell carcinoma (SCC) of the tongue treated from 1979-1994 were reviewed. Results. Patients had a mean age of 61.1 years and a 1.5:1 male to female ratio. Approximately, half of the cancers were diagnosed at an advanced stage and most involved the base of the tongue. The majority of oral tongue tumors were diagnosed at an early stage and had more well-differentiated cell types than those of the base of the tongue. Localized discomfort was the most common complaint (66.5%), present for up to 6 months in patients prior to diagnosis and were related to the oral tongue in 90% of cases. Symptoms associated with base of tongue lesions included neck masses, dysphagia, ear pain, and weight loss. Seventy-nine percent of the patients smoked, 58% consumed alcohol on a daily basis, and 43% consumed more than 4 alcoholic drinks daily. Primary radiotherapy was the treatment of 49.6% lesions, of which 57% were at an early stage at diagnosis. The mean overall survival was 3 years and 5 months, with a 5-year overall survival of 40%. Patients with stage 1 tumors had a disease-specific survival of over 80%. The 5-year survival of patients with cancer of the oral tongue was 43% and cancer of the base of the tongue was 27%. Conclusion. The prognosis is poorer for patients presenting with advanced stage and with tumors involving the base of the tongue. Symptoms were more common in tumors of the oral tongue, which likely results in earlier diagnosis. Patients with SCC of the base of the tongue presented with advanced stage of disease and were typically poorly differentiated lesions.