The management of the oropharyngeal anterior wall cancer

Vol. 59 No. 1, 2018

ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY

Nicolae Constantin Balica, Marioara Poenaru, Caius Ion Doros, Flavia Baderca, Maria-Alexandra Preda, Vasile Ciprian Iovan, Horia Tudor Stanca, Cristina Jana Busuioc, Ioana Cristina Opriscan, Ovidiu Boruga

Introduction: Anterior wall of the oropharynx or the base of the tongue is the site of different types of cancers, most of them usually diagnosed in advanced stages. The most common histological type of cancer diagnosed in these patients is squamous cell carcinoma (SCC). The treatment methods are multiple, but the optimal therapeutic option with best results on outcome and on the patients quality life has not been established. The objectives of our study were to evaluate the tongue base SCCs treated by transhyoid approach and the oncological outcomes of the surgery combined with radiotherapy. Patients, Materials and Methods: The retrospective study was performed over a period of 10 years (2001-2010) on 37 previously untreated patients. All the tumors were biopsied and after histopathological (HP) diagnosis, the tumors were excised. All the specimens were fixed in 4% (v/v) buffered formalin and sent for the HP evaluation. Results: In the study were included only the patient diagnosed on biopsy with different types of SCC. The mean age was 61 years old, most of the patients (94.59%) being males. We performed a tongue base transhyoid tumor resection in 23 (62.17%) cases followed by epiglottectomy in five (13.51%) cases or horizontal supraglottic laryngectomy in nine (24.32%) cases, respectively. Bilateral neck dissections and postoperative radiotherapy were performed in all cases. The postoperative and post-therapeutic evolution was favorable at three years (81.1%) and five years (75.67%). There were no signs of local or regional recurrences. The tumor specific three-year and five-year survival rates were: pT2 100%, pT3 87.5%, pT4a 71.42% and 57.14%, and pT4b 50% and 25%, respectively. The stage specific three-year and five-year survival rates were: stage II 100%, stage III 85.71%, stage IVA 83.33% and 79.16%, and stage IVB 50% and 25%, respectively. Conclusions: The prognosis for the SCC of the tongue base is poor. Cancer resection by transhyoid approach is a feasible procedure, which permits a good tumor control with limited postoperative morbidity, with an important benefit on the life quality of the patients.

Corresponding author: Vasile Ciprian Iovan, Associate Professor, MD, PhD; e-mail: dr.iovan@biostandard.ro; Horia Tudor Stanca, Associate Professor, MD, PhD; e-mail: balica@umft.ro

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