Compartmental surgery for oral tongue and floor of the mouth cancer: Oncologic outcomes

Head Neck. 2019 Jan;41(1):110-115. doi: 10.1002/hed.25480. Epub 2018 Dec 11.

Abstract

Background: Oral tongue/floor of mouth squamous cell carcinoma (OTFMSCC) with a depth of invasion (DOI) > 10 mm involves extrinsic muscles and lingual neurovascular/lymphatic bundles. "Compartmental" hemiglossopelvectomy (CHGP) was developed to improve loco-regional control by "en bloc" removal of tumor and its pathways of spread.

Methods: We conducted a retrospective observational study on 45 CHGPs performed at a single institution for OTFMSCC with a DOI > 10 mm at CT/MR. Group A (n = 35) included naïve patients, and group B (n = 10) recurrent cancers. We evaluated 2-year overall survival (OS), disease-free survival (DFS), local control (LC), and loco-regional control (LRC).

Results: Two-year OS, DFS, LC, and LRC were 80%, 91%, 100%, and 94% for group A, and 27%, 26%, 67%, and 36% for group B, respectively. Salvage surgery and positive margins were significantly associated with worse prognosis.

Conclusion: CHGP is a reliable oncologic approach in primary surgery for advanced OTFMSCC. In recurrent cancers, survival remains poor.

Keywords: compartmental surgery; floor of mouth; hemiglossopelvectomy; oral tongue; squamous cell carcinoma.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Disease-Free Survival
  • Female
  • Free Tissue Flaps
  • Humans
  • Male
  • Margins of Excision
  • Middle Aged
  • Mouth Floor / surgery*
  • Mouth Neoplasms / mortality
  • Mouth Neoplasms / pathology
  • Mouth Neoplasms / surgery*
  • Muscle, Skeletal / surgery
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local
  • Oral Surgical Procedures / methods*
  • Retrospective Studies
  • Tongue Neoplasms / mortality
  • Tongue Neoplasms / pathology
  • Tongue Neoplasms / surgery*