Carcinoma of the tongue and floor of the mouth. Preliminary results of a multidisciplinary approach.

UNLABELLED

Eighty-five patients (74 males, 11 females) with untreated squamous-cell carcinoma of the tongue (40 patients) and the floor of the mouth (45 patients) underwent a multidisciplinary treatment.

FOLLOW-UP: 6-72 months (median 52 months). T1-4N0M0 lesions (tongue; 32 patients; floor of mouth, 32 patients) were treated with cryosurgery (T1-2: 1-2 sessions, T3-4: 2-4 sessions) and contemporaneously with CMF (cyclophosphamide, methotrexate, fluorouracil) (T1-2: 2 courses; T3-4: 3 courses). 15-20 days after the end of cryo-chemotherapy the patients underwent TCT (T1: 50 Gy to the tumour and lymph nodes; T2-3-4: same with an extra dose of 10-15 Gy to the primary lesion). T1-4N1-3M0 patients (tongue: 8, floor of mouth: 13) received the same cryotherapy and chemotherapy, followed by surgery (13 extended suprahyoid dissections, 8 conservative laterocervical dissections, 1 RND). The actuarial survival rate of patients with tongue tumours after 6 years was 81.4% (N0 87.1%; N+ 60.0%). Four months after treatment, 35 patients had reached complete remission (CR). The probability of remaining in CR for 6 years was 53.6% (N0 56.1%; N+ 50.0%). For tumours of the floor of the mouth the actuarial survival rate was 55.2% (N0 56.5%; N+ 48.6%). Four months after treatment, 38 patients had reached CR. The probability of remaining in CR for 6 years was 59.9% (N0 61.5%; N+ 59.3%). A controlled study is recommended in the light of these results and the conservative nature of the protocol.