Clinicopathological Analysis of Local Spread of Carcinoma of the Tongue

doi:10.1016/S0002-9610(97)00282-1

The American Journal of Surgery

Volume 175, Issue 3, March 1998, Pages 242-244

https://doi.org/10.1016/S0002-9610(97)00282-1 Get rights and content

Abstract

Background: The aims of the study are three-dimensional analysis of mode and distance of local spread of oral tongue carcinoma.

Methods: The glossectomy specimens were examined in the coronal plane in 3 mm thickness section.

Results: There were 50 glossectomy specimens. The maximum spread was 1.8 cm. Ninety-six percent of specimens had local spread within 1.2 cm. The distance of spread was not correlated with tumor size, including the diameter, depth, and volume. The incidence of local recurrence was 27% with positive histological margin. Perineural infiltration was the most important prognostic factor for local recurrence and survival.

Conclusions: A minimum of 1.5-cm surgical resection margin is recommended. A smaller margin is not recommended as it has significant risk of local recurrence. A maximum of 2-cm surgical resection margin is recommended; larger margins will increase the surgical morbidity without a significant advantage of local control.

Section snippets

Methods

A total of 50 glossectomy specimens of squamous cell carcinoma of oral tongue were included for whole-organ serial sectioning from the Department of Surgery, the University of Hong Kong, Queen Mary Hospital, Hong Kong, from January 1989 to February 1995.

The glossectomy specimens were fixed on a foam board by pins during the process of formalin fixation to prevent shrinkage of tissue. The specimens were then sectioned in coronal plane into blocks of 3 mm thickness. Sections were cut from these

Results

All 50 patients had squamous cell carcinoma of oral tongue. There were 28 male and 22 female patients. The median age was 56 years (range 16 to 86, SD 19). Forty-five patients received primary surgical treatment and the other 5 patients had prior radiotherapy failures with surgical salvage for local recurrence. The preoperative clinical stages were 13 T1 (12 N0, 1 N2), 28 T2 (25 N0, 3 N1), and 9 T3 (6 N0, 2 N1, 1 N2). There were 28 well-differentiated, 21 moderately differentiated, and 1 poorly

Comments

Tumors are three-dimensional structures. When the three-dimensional tumor size is not accurately documented, surgical resection may not be adequate, and this factor may account for the positive resection margin and local recurrence. When the tumor size is overestimated, it may result in unnecessary excess resection of normal tissue and gives rise to more surgical morbidity. There are reports on the more accurate T-staging of oral carcinoma by using ultrasound, computed tomography, and magnetic

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¹: The study was supported by a research grant from the University of Hong Kong, grant number 337/048/0014 and 335/048/0081.

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Brief ReportsClinicopathological Analysis of Local Spread of Carcinoma of the Tongue 1

Abstract

Section snippets

Methods

Results

Comments

Am J Surg

Int J Radiat Oncol Biol Phys

Am J Surg

Clin Radiol

Resection margin as a predictor of recurrence at the primary site for T1 and T2 oral cancers

Arch Otorhinolaryngol Head Neck Surg

Brief Reports
Clinicopathological Analysis of Local Spread of Carcinoma of the Tongue ¹