Carcinoma of the floor of the mouth

Treatment of 377 patients with squamous cell carcinoma of the floor of the mouth has been studied. Almost two-thirds (235) of the patients had T1 or T2 tumors and a similar number (242) were free of cervical metastases. The median age was 60 years and men predominated over women 4:1. Irradiation, the first treatment of 330 (87.5%) patients, produced a five-year actuarial survival rate of 40%. For stages T1-2 No and T3-4 No such survival rates were 57% and 31% respectively. Regional metastases were the most important prognostic factor and their development reduced survival: if controlled the five-year survival rate was 33% against 17.5% when they were not. Among 221 treated failures, 122 (54%) had persistent disease at three months, and recurrent disease was detected within two years in 93%. A second treatment was successful in 56 (49%) of 115 patients in whom disease recurred either at the primary or secondary sites but only in 13 (24%) of 54 with uncontrolled disease at both sites. Tragically 101 (27%) patients developed other cancers: 69 in the aerodigestive tract and 26 in the lung.