A clinical study on carcinoma tongue-a prospective analytical study in a tertiary cancer care centre in coastal andhra pradesh

Back ground: The incidence of tongue cancer is increasing in the recent time in India. High risk of neck metastasis is seen in tongue cancer. Tongue cancer is best treated with multimodality approach
Aims and Objectives: To analyze the clinical and pathological data, prognosis and treatment modalities in a series of cases of carcinoma tongue and compare our study with similar other studies.
Materials and methods: A Prospective clinico-pathological study of 170 cases of carcinoma tongue in tertiary cancer centre for a period of 3 years from April 2014 to March 2017. Patients with confirmed diagnosis of Ca tongue were included in the study. The data analyzed were most common age group of presentation, gender preponderance, most common stage at presentation along with the most common histo-pathological type with the most common grade. We assessed the nodal involvement at presentation, and the different treatment modalities offered to patients.
Results: 170 cases of carcinoma tongue are included in this study of which 150 cases are in anterior two-thirds of tongue, 15 cases are in posterior one-third of tongue and 5 cases presented with anterior and posterior tongue involvement. Male to female ratio 2.5 : 1. Mean age of diagnosis 51.9 years. Left side involvement is most common (56%). Palpable neck nodes in 110 cases (64%). Occult lymph node disease in 33.3%. Stage III and grade II most common presentation. Primary chemo-radiotherapy is given for posterior one third involvement of tongue; all the other cases are taken up for surgery - wide local excision / hemiglossectomy/ resection & PMMC reconstruction. Extended supra-omohyoid / MRND done and post-operative chemo/radiotherapy given as appropriate. Recurrence either at primary site or neck was noted in 17 patients (10%) within the study period.
Conclusion: In this study we conclude that tongue cancer is most common in males 30- 60 years age; lateral aspect of anterior two-thirds of tongue being most common site. Tongue cancer has high risk of both palpable and occult lymph node disease in neck; neck dissection offers better disease control. Patient of tongue cancer should be treated in multi disciplinary approach to achieve good prognosis.