Carcinoma of the tongue: factors affecting the results of surgical treatment.

Sixty-five cases of carcinoma of the tongue treated by surgery were reviewed. The types of operation included hemiglossectomy, subtotal and total glossectomy with or without hemimandibulectomy and laryngectomy. Simultaneous neck dissection was usually performed except for patients who had radiotherapy and did not have clinical lymph node involvement. The hospital mortality and five-year survival rates were analysed for individual subgroups of patients classified according to clinical and pathological features. The overall hospital mortality rate was 21.5 per cent. The size of the tumour and the presence of extension posteriorly, to the opposite side and to the floor of the mouth increased the mortality. Lesions situated on the dorsum fared worse than those at the edge or undersurface. Clinically and pathologically involved lymph nodes adversely affected the mortality. The more extensive the resection, the higher the mortality. Old age and previous failed radiotherapy also increased mortality. The overall five-year survival rate was 46 per cent. Long term survival was not so much affected by the size of the primary tumour and degree of local extension as was the hospital mortality. Clinical as well as pathological staging of regional lymph nodes were more important in influencing long term survival. Recurrence after radiotherapy had a worse prognosis than previously untreated tumours.