Management of advanced carcinoma of the base of tongue

Base-of-tongue carcinoma is a relatively rare disease with aggressive behavior and poor prognosis. Up to date no consensus exists regarding the ideal management strategy for each stage of the disease. This study aims to evaluate the experience of a single head and neck oncology center in the management of advanced stage base-of-tongue cancer.

A retrospective evaluation of cases primarily treated for stage III/IV(A-B) base-of-tongue carcinoma, between 1980 and 2007, at a tertiary referral center.

A total of 366 cases were studied. Five-year disease specific survival (DSS) was 42% and local control (LC) 80%. Regional and distal control estimates were 91.3 and 84%, respectively. Prognosis was significantly superior for cases receiving surgery plus adjuvant treatment compared to cases solely managed with non-surgical modalities. Positive surgical margins and regional disease significantly worsened prognosis. Satisfactory retention of pharyngeal function and no fatal complications were noted in surgical cases.

Although no consensus exists regarding ideal therapy for advanced base-of-tongue carcinoma, combined strategies with the use of surgery and adjuvant chemoradiotherapy (CRT) seem to offer the best possibility for a positive outcome.