A descriptive study highlighting the differences in the treatment protocol for oral tongue cancer in Sweden and Finland

Abstract

Background and aims: Stage II cancer of the tongue is mostly managed surgically both locally and regionally. However, indications for postoperative radiotherapy and reconstructive options vary between centers. This paper aims to describe differences in treatment in a geographically homogenous cohort.

Methods: A retrospective comparison was made between two cohorts of clinical T2N0 tongue cancer from Finland and Sweden. The Finnish cohort included 75 patients and the Swedish 54. All patients had curative intent of treatment and no previous head and neck cancer. Data analyzed consisted of pathological stage, size and thickness of tumor, frequency of reconstruction, radiotherapy delivered, and survival.

Results: The Finnish cohort included a higher proportion of patients managed with reconstructive surgery (67%) than the Swedish cohort (0%), p < .00001. More patients were treated with postoperative radiotherapy (84%) in the Swedish cohort than in the Finnish (54%), p < .0002. The Finnish cohort had a higher level of survival and included more frequent downstaging (cTNM to pTNM).

Conclusions and significance: Our data indicate a major difference in the management of T2N0 oral tongue cancer. The optimal cut-off size and growth pattern of the tumor warranting reconstruction should be further evaluated in a prospective manner considering both survival and quality of life.

Chinese abstract

背景与目的：II期舌癌多为局部或区域手术治疗。然而, 术后放射治疗和重建选择的标示因中心而异。本文旨在描述对地理上同质的患者群治疗上的差异。

方法：回顾性比较芬兰和瑞典两组临床T2N0舌癌患者的临床资料。芬兰组包括75名患者, 瑞典组54名。所有患者均具有治疗目的, 无头颈部恶性肿瘤。所分析的数据包括病理分期、肿瘤大小和厚度、重建频率、放射治疗和生存率。

结果：芬兰组中接受重建手术的患者比例（67%）高于瑞典组（0%）, p<0.00001。瑞典组中接受术后放射治疗的患者（84%）多于芬兰组（54%）, p <0.0002。芬兰组的生存率较高, 并包括更高频率的降阶（从cTNM到pTNM）。

结论与意义：我们的数据表明, 在治疗T2N0口腔舌癌方面存在重大差异。应以考虑生存率和生活质量这种前瞻性的方式进一步评估肿瘤最佳切除大小和生长模式, 以确保舌重建。

Keywords:

• Tongue cancer
• reconstruction
• outcome
• recurrence

Disclosure statement

No conflicts of interests were reported from any of the authors.

Additional information

Funding

Financial support provided by The Laryngeal Foundation, Karolinska Institutet and the Stiftelsen Acta Oto-Laryngologica Foundation in Sweden and the Helsinki University Hospital Research Fund and the Finska Läkaresällskapet in Finland.