Early stage carcinoma of oral tongue: prognostic factors for local control and survival

Abstract Background The purpose of the study was to evaluate survival outcomes in post-operative oral tongue cancer patients undergoing adjuvant radiotherapy (RT) at a tertiary cancer care center and to critically review the impact of various clinical-pathological factors on recurrence and survival. Demographic factors, stage of all the histology proven oral tongue cancer, and treatment details were documented. Overall survival (OS) and recurrence-free survival (RFS) were analyzed along with the potential prognostic factors affecting outcome. Results One hundred forty-four post-operative oral tongue cancer patients referred to our department for adjuvant treatment were evaluated. Median age at presentation was 45 years. Forty-seven patients had pathological early stage disease (stages I and II) and 95 had locally advanced (stages III and IV) disease while post-op details were not present in 2 patients. At a median follow-up of 87 months (60–124) of alive patients, the median RFS for entire cohort was 62 months while median OS was 74 months respectively. Age, perineural invasion (PNI), and grade of the tumor emerged as independent prognostic factors for OS and RFS. Among patients with early stage disease, depth of invasion (DOI), age, and PNI were found as independent prognostic factors for RFS and OS. In locally advanced disease, higher grade, age, and PNI independently impacted the respective survival end points. Conclusions Age (> 45 years), higher grade, and presence of PNI showed inferior survival outcomes across the sub-groups (early versus locally advanced disease). This may warrant adjuvant treatment intensification. DOI > 10 mm was particularly found to worsen survival in early node negative SCC oral tongue patients.

Download Full-text

Assessment of Influence of Smoking, Drinking, Leukoplakia and Dental Irritation on Local Control of Early Oral Tongue Carcinoma Treated with Brachytherapy: Age and Dental Factors are Potential Prognostic Factors

Tumori Journal ◽

10.1177/030089160909500409 ◽

2009 ◽

Vol 95 (4) ◽

pp. 461-466 ◽

Cited By ~ 4

Author(s):

Hideya Yamazaki ◽

Takehiro Inoue ◽

Ken Yoshida ◽

Tadayuki Kotsuma ◽

Yasuo Yoshioka ◽

...

Keyword(s):

Prognostic Factors ◽

Elderly Patients ◽

Local Control ◽

Tongue Cancer ◽

The Elderly ◽

Local Control Rate ◽

Factor Group ◽

Elderly Group ◽

Control Group ◽

Oral Tongue

Background To examine the background characteristics of elderly patients (65 years or older) with node-negative mobile tongue cancer (T1-2N0M0) who showed worse local control than a younger group. Materials and methods We retrospectively analyzed background data for 265 patients treated with brachytherapy with or without external radiotherapy between 1967 and 1999. We examined dental factors (such as irritation by prosthesis), leukoplakia, tobacco smoking and alcohol consumption for comparisons between the elderly (age ≥65 years; n = 83) and a control group (64 years or younger; n = 182). Results The elderly patients showed a worse outcome than the control group (respectively 86% and 70% at 5 years; P <0.05). Incidence of dental factors tended to be higher for elderly patients (53%) than the control group (40%, P = 0.07). Dental factors proved to have prognostic importance for local control. Five-year local control rate was 85% for patients with and 76% for patients without dental factors (P = 0.04). The elderly group positive for dental factors showed a lower 5-year local control rate (61%) than the other three groups [(elderly without the dental factor (–) group (80%), control with the dental factor (+) group (84%), and control without the dental factor (–) group (87%)] (P <0.05). Leukoplakia was found more frequently in the control (23%) than in the elderly group (5%) (P = 0.006) but had no effect on treatment outcome. Conclusions Age and dental factors (including prosthesis irritation) are potentially important prognostic factors for local control of oral tongue cancer treated with brachytherapy, especially for elderly patients.

Download Full-text

Clinical Outcome of CT-Guided Stereotactic Ablative Brachytherapy for Unresectable Early Non-Small Cell Lung Cancer: A Retrospective, Multicenter Study

Frontiers in Oncology ◽

10.3389/fonc.2021.706242 ◽

2021 ◽

Vol 11 ◽

Author(s):

Zhe Ji ◽

Bin Huo ◽

Shifeng Liu ◽

Qinghua Liang ◽

Chao Xing ◽

...

Keyword(s):

Lung Cancer ◽

Multivariate Analysis ◽

Prognostic Factors ◽

Chest Wall ◽

Local Control ◽

Early Stage ◽

Small Cell ◽

Small Cell Lung ◽

Ct Guided ◽

Early Stage Nsclc

ObjectiveTo analyze the efficacy and safety of low dose rate stereotactic ablative brachytherapy (L-SABT) for treatment of unresectable early-stage non-small cell lung cancer (NSCLC).MethodsData of patients with early-stage NSCLC who received CT-guided L-SABT (radioactive I-125 seeds implantation) at eight different centers from December 2010 to August 2020 were retrospectively analyzed. Treatment efficacy and complications were evaluated.ResultsA total of 99 patients were included in this study. Median follow-up duration was 46.3 months (6.1-119.3 months). The 1-year, 3-year, and 5-year local control rates were 89.1%, 77.5%, and 75.7%, respectively. The 1-year, 3-year, and 5-year overall survival rates were 96.7%, 70.1%, and 54.4%, respectively. Treatment failure occurred in 38.4% of patients. Local/regional recurrence, distant metastasis, and recurrence combined with metastasis accounted for 15.1%, 12.1%, and 11.1%, respectively. Pneumothorax occurred in 47 patients (47.5%) with 19 cases (19.2%) needing closed drainage. The only radiation-related adverse reaction was two cases of grade 2 radiation pneumonia. KPS 80–100, T1, the lesion was located in the left lobe, GTV D90 ≥150 Gy and the distance between the lesion and chest wall was < 1 cm, were associated with better local control (all P < 0.05); on multivariate analysis KPS, GTV D90, and the distance between the lesion and chest wall were independent prognostic factors for local control (all P < 0.05). KPS 80–100, T1, GTV D90 ≥150 Gy, and the distance between the lesion and chest wall was < 1 cm were also associated with better survival (all P < 0.05); on multivariate analysis KPS, T stage, and GTV D90 were independent prognostic factors for survival (all P < 0.05). The incidence of pneumothorax in patients with lesions <1 cm and ≥1cm from the chest wall was 33.3% and 56.7%, respectively, and the differences were statistically significant (P = 0.026).ConclusionL-SABT showed acceptable efficacy in the treatment of unresectable early-stage NSCLC. But the incidence of pneumothorax is high. For patients with T1 stage and lesions <1 cm from the chest wall, it may have better efficacy. Prescription dose greater than 150 Gy may bring better results.

Download Full-text

Early-stage vaginal carcinoma – an analysis of 70 patients

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200403000-00017 ◽

2004 ◽

Vol 14 (2) ◽

pp. 304-310

Author(s):

G. R. Otton ◽

J. L. Nicklin ◽

G. J. Dickie ◽

P. Niedetzky ◽

L. Tripcony ◽

...

Keyword(s):

Prognostic Factors ◽

Local Control ◽

Early Stage ◽

Squamous Cell Carcinomas ◽

Prognostic Indicators ◽

Combined Surgery ◽

Vaginal Carcinoma ◽

Initiation Of Therapy ◽

Grade 3 ◽

Time To Relapse

ObjectivesThe aims of this study were to assess outcomes and define prognostic factors for early-stage vaginal carcinoma.MethodsA retrospective analysis was performed of women with FIGO stages I and II vaginal carcinoma identified from the database of the Queensland Centre for Gynaecological Cancer between January 1982 and December 1998.ResultsSeventy women were identified. The 5-year survivals for stages I and II carcinomas were 71 and 48%, respectively (P < 0.05). Sixty-one patients (87%) had squamous cell carcinomas with a 5-year survival of 68% versus 22% for adenocarcinomas (P < 0.01). Those women with grade 3 tumors had a 5-year survival of 40% versus 69% for grades 1 and 2 (P < 0.05). Tumor size and site were not significant prognostic factors. Patients treated by surgery alone or with combined surgery and radiotherapy had a significantly improved survival compared to the radiation alone group (P < 0.01). Eighty-five percent of recurrences were locoregional. The median time to relapse was 12 months after initiation of therapy.ConclusionTumor morphology, grade, and stage are important prognostic indicators. Measures aimed at improving local control of the disease, including surgery, are necessary.

Download Full-text