Risk factors for postoperative local recurrence of tongue carcinoma

Objective: To identify the clinicopathologic factors associated with postoperative local recurrence in patients with carcinoma of the tongue. Patients and Methods: Clinicopathologic factors were reviewed in 50 patients seen between 1985 and 1996 with previously untreated stage I or stage II squamous cell carcinoma of the tongue. All of the patients underwent partial glossectomy without elective neck dissection. Postoperative local recurrence occurred in 13 patients (26.0%) within 8 to 16 months of surgery for the primary tumour. Clinicopathologic factors were analysed using logistic regression to determine factors predicting postoperative local recurrence of tongue carcinoma. Results: Postoperative local recurrence was positively associated with tumour size (≥30 mm), tumour thickness (>4 mm), and epithelial dysplasia score within 3 mm of the surgical margin (≥4 points). In a multivariate logistic regression analysis, patients with epithelial dysplasia score of ≥4 points within 3 mm of the surgical margin had a predictive value for postoperative local recurrence (odds ratio, 36.6; p < 0.0001). Conclusions: Patients with an epithelial dysplasia score of ≥4 points within 3 mm of the surgical margin have a higher risk of postoperative local recurrence. It is recommended that this diagnostic factor be used in deciding about re-excision or additional therapy.