Observation as an option for epithelial positive margin after partial glossectomy in stage I and II squamous cell carcinoma: analysis of 365 cases

Jpn J Clin Oncol. 2013 May;43(5):520-3. doi: 10.1093/jjco/hyt021. Epub 2013 Feb 26.

Abstract

Objective: This study was conducted to assess local recurrence and clinical prognosis in patients diagnosed as having a positive margin in the epithelial layer after a partial glossectomy treated by close observation.

Methods: A total of 365 cases of squamous cell carcinoma of the tongue diagnosed as clinical Stage I or II, treated by partial glossectomy in the National Cancer Center Hospital East between 1992 and 2006, were studied retrospectively.

Results: Pathological findings showed that 13 cases had positive margins in the epithelial layer, 4 (30.8%) of whom showed up with local recurrence in 4.4 years (3.0-5.0) on average. Lymph node recurrence was not observed and the 5-year overall survival rate was 76.2% in those 13 cases. The treatment for the recurrent cases was an additional partial glossectomy without neck dissection, which resulted in no recurrence and a survival rate of 100% after an average follow-up of 6.7 years.

Conclusions: We suggest careful observation as one option for cases diagnosed with epithelial positive margin.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / surgery*
  • Female
  • Follow-Up Studies
  • Glossectomy / methods*
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / prevention & control*
  • Neoplasm Staging
  • Prognosis
  • Reoperation
  • Retrospective Studies
  • Survival Analysis
  • Tongue Neoplasms / pathology*
  • Tongue Neoplasms / surgery*
  • Treatment Outcome
  • Watchful Waiting*