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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the past 18 years 34 patients (21 males and 13 females) with carcinoma of the tongue were treated in the author's clinic. Patients with T1N0 lesions were treated satisfactorily only with irradiation. Patients with advanced disease, such as T2-T4 with metastases, were classified into 2 groups. One group was treated surgically (hemiglosectomy and radical neck dissection) and postoperative irradiation (about 6000 rads). The other group was treated with preoperative irradiation (about 4000 rads) and the same operation as the first groups. The results are significantly different. In the first group, 15 patients out of 17 died from local or cervical recurrences, whilst in the latter group 12 patients of 14 are in good health. As two patients died from unknown disease the 5 year survival of this group is 100%.
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PMID:[The treatment of carcinoma of the tongue (author's transl)]. 88 44

The records of 340 patients treated surgically over the 20 year period 1950 through 1969 at this clinic for primary epidermoid carcinoma of the anterior two-thirds of the tongue were reviewed to evaluate the effectiveness of elective versus therapeutic radical neck dissection in their treatment. There has been a change in the clinical presentation of this disease, with more people presenting at an earlier stage, with a smaller primary lesion and fewer cervical node metastases. The over-all survival rate has shown a marked improvement to 69 per cent at five years. The proportion of women afflicted has increased. The status of the cervical nodes is a major prognostic factor, the determining five year survival rate being reduced from 78 to 26 per cent if the nodes are metastatically involved. It cannot be directly proved that removal of occult metastasis to the neck by elective radical neck dissection before nodes are clinically detectable leads to a better survival rate partly because the two groups being compared are selected and not randomly assigned. However, the marked tendency for carcinoma of the tongue to metastasize regionally at some time in its course, the significant error in clinical evaluation of the neck, the significant conversion of clinically negative nodes to positive in patients not treated with radical neck dissection, the poor prognosis after treatment of conversion from clinically negative into positive and the fact that more than half of the deaths are due to uncontrolled disease of the neck alone, make us strongly favor the principle of elective radical neck dissection to enhance the survival time in the group of patients without clinical evidence of nodal involvement. With current surgical expertise, the mortality and morbidity rates of simultaneous radical neck dissection are low, and the potential benefit of the procedure outweighs its potential risks. Obviously, elective radical neck dissection, if beneficial, would most likely be so in patients with the highest likelihood of having occult metastasis.
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PMID:Neck dissection in the treatment of carcinoma of the anterior two-thirds of the tongue. 93 54

In a series of 49 patients with epidermoic carcinoma of the tongue microscopy of the primary biopsy was performed, using a multifactorial grading system consisting of 8 parameters, each of 4 grades. The score value (degree of malignancy) revealed a statistically significant correlation with the frequency of regional metastases. As this was particularly marked in the T1 and T2 groups, it seems to be an important supplement to the clinical evaluation of risk groups.
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PMID:Epidermoid carcinoma of the tongue. Histologic grading in the clinical evaluation. 122 92

One hundred and forty nine patients with carcinoma of the tongue or floor of mouth were treated with interstitial irradiation (+/- external beam therapy) using caesium needles or iridium wires between 1970 and 1986. Multivariate analysis showed the main predictors of outcome to be tumour stage, site and histology. Caesium and iridium techniques gave similarly good local control rates of 90% at 5 years for T1 and T2 tumours when used as the standard departmental method. Local failure was shown to have a major impact on the risk of dying from disease and elective neck irradiation (ENI) conferred a favourable benefit on neck control and survival provided the primary site was controlled. Patients less than 40 years of age appeared to have an unfavourable prognosis. Radical irradiation including interstitial techniques gives excellent results in early oral cancer and is the treatment of choice for T2 tumours. We recommend elective neck irradiation in patients at high risk of developing lymph node metastases.
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PMID:Interstitial irradiation for carcinoma of the tongue and floor of mouth: Royal Marsden Hospital Experience 1970-1986. 192 54

The survival rates of 58 patients treated for squamous carcinoma of the tongue between 1972 and 1985 were evaluated. The overall 5-year survival rate was 41.6%; for stage I it was 61.8%; stage II 59.5%; and stage III, 27.7%. No patient survived for more than 2 years when their tumour was stage IV on presentation. A composite pull-through resection with radical neck dissection gave a 5-year survival rate of 50.7%, which was significantly (P less than 0.01) higher than the 13.8% achieved by other treatments, mainly local tumour excision combined with radiation therapy. The same trend in favour of radical surgery was also seen stage by stage. In 45% of the patients regional neck metastases (palpable in 35% and occult in 10%) were present and predicted a poor prognosis. Among T1-T2 cases the 5-year survival of 58.5% in the N0 group was significantly (P less than 0.01) higher than the 15.1% among those with nodal involvement. The location of the primary tumour did not affect the survival rates.
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PMID:Radical surgery for lingual cancer. 239 23

One hundred and one patients of less than seventy years old with T1, T2 and N0 carcinoma of the tongue were graded according to the Jacobson-Yamamoto's grading (1-4 D). All patients were also classified into two groups such as less than fifty years old group and fifty to seventy years old group. Patients with grade 3, 4 C and 4 D carcinoma had more metastases to the cervical lymph nodes than grade 1, 2. Patients with T2N0 carcinoma showed approximately same five year cervical lymph node metastases free survival rate. However, the five year survival rate of less than fifty years old group was significantly lower than that of fifty to seventy years old group. In T2N0, grade 3-4 D carcinoma cases, more dead cases were found in less than fifty years old group than in fifty to seventy years old group.
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PMID:[Interstitial radiotherapy of carcinoma of the tongue-comparison between Jacobson-Yamamoto grading and prognosis]. 258 30

The factors relating to lymph node metastasis occurring in association with carcinoma of the tongue have been investigated clinically and histopathologically by many authors. Nevertheless, accuracy in predicting lymph node metastasis has not yet been attained. The present study describes the results of analysis performed in an attempt to predict lymph node metastasis of carcinoma of the tongue. Ninety-eight patients with squamous cell carcinoma of the tongue who were treated at our institution were investigated. Among the 98 patients, lymph node metastases were histologically proven after neck dissection in 40 patients. For statistical analysis in the present study, the quantification theory Type II of Hayashi (1954) was employed for discriminatory analysis. According to this discriminatory analysis, the correlations between the clinical (age, tumour size, N-category) and histopathological (degree of keratinization, mitoses, structure, mode of invasion) findings and metastasis were assessed on the basis of the partial correlation coefficients; these coefficients for each finding were not greatly different from each other and 74 out of 98 patients (76%) could be differentiated between patients with metastasis and without metastasis accurately. The prediction of lymph node metastasis by such discriminatory analysis had significant validity.
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PMID:Cervical lymph node metastasis in carcinoma of the tongue. Correlation between clinical and histopathological findings and metastasis. 342 38

Surgery for cancer of the tongue and floor of the mouth has become more varied and generally more conservative, influenced by advances in oncology and modern reconstructive methods. Combined therapy is favored, with postoperative irradiation and sometimes adjunctive chemotherapy, using cis-platinum. T1 carcinomas of the tongue and floor of the mouth can be treated with either wide local excision or irradiation alone, but surgery is the preferred method. T2-T4 tumors treated by resection combined with radiation therapy promise the best results. The indications and principles of the most important operative procedures are discussed: local excision; partial and total glossectomy; excision of the floor of the mouth with marginal mandibular resection; composite resection. Mandible sparing operations such as a modification of the "pull through" technique described by Stell or temporary splitting of the mandible are oncologically safe in many cases. A radical neck dissection is indicated in each carcinoma of the tongue or floor of the mouth with palpable lymph nodes. If no nodes are palpable, an elective neck dissection appears justified in view of the high frequency of clinically occult lymph node metastases. Reconstructive measures following radical tongue and floor of the mouth operations are required for regaining mobility of the remaining tongue, for reconstruction of the floor of the mouth and for replacement of the mandible. For immediate reconstruction, the most frequently used technique is the pectoralis major myocutaneous flap which has largely replaced the previously employed local and regional flaps. A significant problem remains with mandibular reconstruction.
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PMID:Surgery for squamous cell carcinoma of the tongue and floor of the mouth. 383 54

Early squamous carcinoma of the tongue (stage I) can be effectively treated by surgery or radiation therapy with good results. In patients with larger, but apparently localized tumors (stage II), we now favor a staging operation (supraomohyoid neck dissection) to select those who require additional treatment directed to the neck. Our preference for patients with advanced tumors (stage III and IV) has shifted to mandible-sparing surgery whenever possible, in combination with postoperative radiation therapy. Using this approach, locoregional tumor control has improved while the morbidity of extraradical surgery and high-dosage radiation therapy has been avoided. This approach may not translate into longer survival times until effective chemotherapy is available to control distant metastases. Meanwhile, there is a need for both public and professional education to increase the proportion of early, curable lesions and promote the necessary changes in lifestyle (i.e., abstinence from alcohol and tobacco) to reduce the incidence of tongue and other cancers of the aerodigestive tract.
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PMID:Squamous cancer of the tongue. 392 60

A series of 45 recurrences in the soft tissues of the neck following lymph node dissection in 497 patients bearing carcinoma of the upper aerodigestive passages is reported. Only 22 cases that presented perilymph node metastases and/or in which there were reasons to indicate insufficient surgical radicality had been subjected to radiotherapy after surgical lymph node dissection; the other 23 cases had not been subjected to radiotherapy because the aforementioned premises had been lacking. All the recurrences therefore occurred in patients with clinically and histologically ascertained metastatic lymph nodes. The presence of perilymph node metastases and the judgment of surgical radicality was thus found insufficient criteria to plan future complementary postoperative radiotherapy. However, even in those cases in which postoperative radiotherapy was performed, there was a rather high incidence of recurrences, as high as 64.7% in patients with carcinoma of the tongue. Our data indicate the opportunity of a clinical trial with preoperative radiation therapy in patients with clinically evident lymph node metastases. Thirty-six of these recurrences were situated in the upper parts of the cervical region. The prognosis is very poor in such cases, so much so that only 2 of our series were disease free at 3 years after the treatment.
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PMID:Recurrences in the soft tissues of the neck after surgery or radiotherapy plus surgery on regional lymph nodes in patients bearing carcinomas of the head and neck. 686 42


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