LANDMARK: The importance of tumor thickness in oral cavity cancer

Article: Long-term regional control and survival in patients with “low-risk”, early stage oral tongue cancer managed by partial glossectomy and neck dissection without postoperative radiation: the importance of tumor thickness

Ganly I, Goldstein D, Carlson DL, et al. Long-term regional control and survival in patients with “low-risk,” early stage oral tongue cancer managed by partial glossectomy and neck dissection without postoperative radiation: the importance of tumor thickness. Cancer. 2013;119(6):1168-76.

This landmark paper determines the incidence of locoregional failure in patients with early stage oral tongue SCC who undergo surgery alone (glossectomy and elective neck dissection).

The study had 164 patients that were gathered from two centers (Princess Margaret & Memorial Sloan Kettering) from 1985-2005  with T1-T2N0 disease. Tumor thickness rather that depth of invasion was used in this study as it was more consistently described in pathology reports.

5 year overall local regional recurrence free survival was 89%. Regional recurrence free survival was 79.9%. Disease-specific survival was 85.6%.

Regional recurrence:⠀61% ipsilateral and 39% contralateral⠀5.7% of tumors were <4mm tumor thickness⠀24% of tumors were >4mm tumor thickness.

Multivariate analysis showed tumor thickness was the only independent predictor of regional failures. Regional recurrence free survival was 94% with tumor thickness <4mm  versus 72% with tumor thickness >4mm.

Patients with >4mm thick oral tongue tumors are at a higher risk for neck failures.

Tumor thickness and has a significant impact on outcomes as seen by the recent addition of DOI to the oral cavity staging system 8th edition. 


PMID: 23184439