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Updated: Jan 18, 2026
Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way
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Neoadjuvant Chemotherapy Followed by Surgery-A Promising Strategy to Reduce Morbidity in Locally Advanced Tongue
G A Deshpande1, S Rai1, A Singh1
1Surgical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
Background:
Though neoadjuvant chemotherapy (NACT) has not improved survival in oral cancers, its role in tongue cancer remains uncertain.
Methods:
This was a retrospective study of patients with locally advanced oral tongue cancer (Stage III-IVB) to assess response rates, mandibular preservation, and surgical extent post-NACT, along with recurrence and survival outcomes.
Results:
Of 72 patients, 20 (27.8%) received NACT, while 52 (72.2%) underwent upfront surgery. In the NACT group, 15 (75%) received TPF chemotherapy for a median of 3 cycles. One patient (5%) had a complete response, and 13 (65%) had a partial response. The clinical benefit rate was 85%. Tumor downstaging occurred in 14 (70%) patients, with 6 (42.9%) requiring less extensive surgery. The mandibular preservation rate was 75%. The pathological complete response was 10%. Local and distant control rates, disease-free survival, and overall survival were comparable.
Conclusion:
Despite its retrospective design and small sample size, this study suggests that NACT can downstage tumors, improve response rates, and enable less extensive surgery in locally advanced tongue cancer.
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