An Analysis of Carcinoma Tongue

Santhi, - (2008) An Analysis of Carcinoma Tongue. Masters thesis, Kilpauk Medical College, Chennai.


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INTRODUCTION: Carcinoma of tongue, one of the commonest site for malignancies of oral cavity has gained importance by virtue of the organ’s anatomical and functional importance. Along with other cancers of oral cavity like cheek, floor of mouth, lip it has a deleterious effect on functions like swallowing, speech, taste and respiration. The presence of premalignant conditions has provided the way for early detection of susceptible persons. With changing life style and increased incidence of tobacco abuse the tongue cancer is on the rise. It is of interest that an increase in tongue cancer has been reported among young adult men. The median age for individuals with tongue cancer is approximately 40 years. Knowledge of tongue’s anatomy along with neck nodes, about 200 in number, is of utmost importance for managing these lesions and to get a better loco-regional control, as most of the failures occur in this level. As with other oral cavity cancers, carcinoma tongue patients, also have the likelihood of developing a second primary tumour elsewhere in the upper aerodigestive tract. This has been attributed to the field cancerisation effect and this should be kept in mind during pre-treatment investigations and post-treatment follow up. Management of these patients should provide a good control of the disease and a better functional outcome in terms of speech and most importantly swallowing. Post-treatment rehabilitation is an essential element in treating these cases. AIM OF THE STUDY: 1. To evaluate association of risk factors with tongue cancers 2. To find out the age specific incidence and male:female ratio 3. To find the stage at presentation 4. To find out the site of commonest presentation anterior or posterior tongue 5. To assess the pattern of cervical metastasis from tongue cancer in relation to T status and location of cancer 6. To find out the number of patients taken for primary radiotherapy and its response 7. To study the role of surgery in management of primary and neck nodes 8. Compare the outcome of surgery following chemotherapy and radiotherapy 9. To study the role of chemotherapy in management of tongue cancer 10. To compare my results with literature MATERIALS AND METHODS: All patients who reported at oncology department diagnosed as a carcinoma tongue at Government Royapettah Hospital were included in the study. The patients either came to department directly or were referred from other departments and other hospitals after proving the malignancy by Histopathological examination. The study period was 25 months from September 2005 to September 2007. Diagnosis was confirmed by HPE of specimen obtained by wedge biopsy of ulcer / growth. Detailed history regarding duration of symptoms, habits like smoking, alcoholism, tobacco chewing were obtained. Baseline investigation which included a complete hemogram, blood biochemistry, X-Ray chest and X-ray mandible as required were done. Special investigation like MRI and CT scan done in few selected cases. A thorough physical examination was done to assess the size and extent of tumour presence or absence of Ankyloglossia, involvement of adjacent structures. Nodal status was assessed clinically. Finally staged according to TNM staging. Early cases categorized to T1-T2 advanced cases to T3-T4. The protocol followed at oncology department GRH is to subject the patient with advanced disease to combined modality compiling Radiotherapy and surgery. Radiotherapy was given as external beam Radiotherapy using radioactive cobalt 60. Dosage used in a range of radiation schedule was 4000-6000 CGY. 200 CGY / day for 5 days a week for 5-7 weeks. CONCLUSION: 1. Smoking, alcoholism, panproducts are most commonly associated risk factors for carcinoma tongue. 2. Most common in 4th to 6th decade of life Males are more commonly affected than females in the ratio of 3:1. 3. Stage III, IV are common presentation in Carcinoma tongue. 4. Anterior 2/3rd is the commonest site of involvement. 5. Nodal involvement was common in T3 and T4 lesions, posteriorly placed lesions. 6. Majority of early lesions (T1 and T2) are best treated surgicaly. 7. Few cases were down staged by using pre operative radiotherapy and chemotherapy followed by surgery. 8. Chemotherapy is mainly palliative measure. 9. The observation and results of the study are in accordance with similar study in literature.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Carcinoma Tongue ; Analysis.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 05 Jun 2018 17:41
Last Modified: 06 Jun 2018 03:30

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