Major glossectomy: end results of 106 cases

Area of Science:

• Oncology
• Surgical Oncology
• Head and Neck Cancer

Background:

• Advanced oral cavity cancers present significant therapeutic challenges.
• Traditional treatments like radiotherapy and chemotherapy have limited long-term efficacy.
• Reconstructive advancements enable major glossectomy as a viable palliative and curative approach.

Purpose of the Study:

• To report surgical complications and prognosis in 106 patients undergoing major glossectomy.
• To evaluate the safety and efficacy of major glossectomy for advanced oral cavity cancers.

Main Methods:

• Retrospective analysis of 106 patients treated between 1985 and 1994.
• Detailed recording of primary tumor sites, tumor stages (TNM), glossectomy types, and neck dissection procedures.
• Documentation of reconstructive methods (pectoralis major myocutaneous flap), complications, and patient outcomes.
• Actuarial survival rate calculation based on tumor stage and other prognostic factors.

Main Results:

• Squamous cell carcinoma was the predominant histology.
• Common complications included wound infection (17%), flap necrosis (15%), and fistula (15%).
• Five-year actuarial survival rates were 45% for T3, 18% for T4, and 18% for Tx stages.
• pN stage and year of admission were significant prognostic variables.

Conclusions:

• Major glossectomy, when performed without laryngectomy, is a safe procedure for selected patients with advanced tongue and floor of mouth cancers.
• The reported survival rates support considering major glossectomy as a treatment option for carefully selected patient cohorts.
• Further research into optimizing patient selection and surgical techniques is warranted.