Gallegos-Hernández JF, Arias-Garzón WR, Arias-Ceballos H, Minauro-Muñoz G, Hernández-San Juan M, Maffuz A, Reséndiz-Colosia JA

Language: Spanish
References: 9
Page: 11-13
PDF size: 67.03 Kb.

ABSTRACT

Introduction: Standard care of patients with oral tongue-invasive squamous cell carcinoma in early stages is local resection and neck dissection. Traditionally, tumor resection was performed with hemiglossectomy (tongue resection in lingual long axis), which implied morbidity for deglutition and speech. Although surgical margins are sufficient, they are usually larger than necessary.
Objective: To know functional results and surgical margins in patients with T1-T2 oral tongue cancer submitted to transverse glossectomy (TG).
Material and methods: We analyzed charts of patients with T1-T2 oral tongue squamous cell carcinoma treated by TG during a 2-year period. We studied surgical margins, deglutition, speech intangibility, performance status and patient satisfaction.
Results: We included 20 patients: 12 women and eight men, with mean age of 45 years. Tumor-thickness mean was 8 mm; 19 patients showed free tumor margins in definitive histology study with mean of 1.8 cm three-dimensionally. In one patient, frozen sections were free-of-tumor, but definitive study showed a microscopic area of squamous cell carcinoma in surgical margin. All patients preserved > 50% of oral tongue and all showed lingual tip deviation and short tongue. None required nasogastric tube for feeding and speech was intelligible in all patients.
Conclusions: TG provided sufficient surgical margin in all patients in this series without important morbidity and with good functional result; thus, TG is an alternative to classic vertical hemiglossectomy for patients in early stages of tongue mobile cancer.

REFERENCES

1. Kaya S, Yilmaz T, Gursel B, et al. The value of elective neck dissection in treatment of cancer of the tongue. Am J Otolaryngol 2001;22: 59-64.

2. Gallegos HJF, Martínez GH, Flores DR. La disección radical de cuello en el cáncer de vías aero-digestivas superiores (VADS). Indicaciones, extensión y radicalidad. Cir Ciruj 2002;70:369-376.

3. Shah JP, Lydiatt WM. Bucal mucosa, alveolus, retromolar trigone, floor of mouth, hard palate and tongue tumors. In: Thawley SE, Panje WR, Batsakis J, Lindberg RD, editors. Comprehensive management of head and neck tumors. Philadelphia, PA, USA: W.B. Saunders, Co;1999. pp. 686-694.

4. De Santo LW, Thawley SE, Genden EM. Treatment of the oropharynx: surgical therapy. In: Thawley SE, Panje WR, Batsakis J, Lindberg RD, editors. Comprehensive management of head and neck tumors. Philadelphia, PA, USA: Saunders, Co.;1999. pp. 806-859.

5. Boyle JO, Strong EW. Oral cavity cancer. In: Shah JP, editor. Cancer of the head and neck. New York: B.C. Decker, Inc.; 2001. pp. 100-126.

6. Gallegos HJF, Flores DR, Reséndiz CJA, et al. Rhenium colloid and blue dye for lymphatic mapping and sentinel node biopsy in oral cavity cancer (abstract). 2nd International Conference on Sentinel Node Biopsy in Mucosal Head and Neck Cancer. Zurich, Switzerland; 2003.

7. Furia CL, Kowalski LP, Latorre MR, et al. Speech intelligibility after glossectomy and speech rehabilitation. Arch Otolaryngol Head Neck Surg 2001;127:877-880.

8. Knunutila H, Pukander J, Maatta T, et al. Speech articulation after subtotal glossectomy and reconstruction with myocutaneous flap. Acta Otolaryngol 1999;119:621-626.

9. Nallet E, Ameline E, Molonguet L, et al. T3-4 cancer of the oral cavity, surgical treatment with oral tongue resection. Ann Otolaryngol Chir Cervicofac 2001;74-77.