A retrospective comparison of treatment outcome in the posterior and anterior tongue

The perceived poor survival for tongue base cancer compared with the anterior tongue influences selection of treatment. Treatment outcome is compared in patients with epidermoid carcinoma of the tongue base (n = 112) and anterior tongue (n = 188). A multivariate Cox's proportional hazard model is used to assess the independent effect of tumor location on survival. Seventy-one percent of patients with tongue base tumors had advanced stages of disease (Stages III & IV) at presentation compared with 32% for the anterior tongue ( P = .000). Disease-specific survival at 5 years for the tongue base was 26%, and for the anterior tongue was 64%. Significant risk factors for disease relapse included age >50 years, advanced stages of disease, and radiotherapy as a single treatment modality. The adjusted hazard ratio for disease relapse for the tongue base compared with the oral tongue was 1.2 (95% CI = 0.83,1.74; P = .332). Treatment response for tongue base and anterior tongue tumors is similar. The pessimism that besets the management of cancer of the tongue base may not be justified in all patients.