Oda, DolphineSebastian, Gale Ann2022-01-262022-01-262022-01-262021Sebastian_washington_0250O_23786.pdfhttp://hdl.handle.net/1773/48234Thesis (Master's)--University of Washington, 2021Background: Oral Squamous Cell Carcinoma (OSCC) is a life-threating condition accounting for 90% of all cancers in the oral cavity (with the majority of cases affecting the tongue). Early and loco-regionally oral tongue squamous cell carcinoma (OTSCC) is treated with surgical resection (glossectomy) with or without neck dissection and postoperative adjuvant therapy. Aim: To describe patient demographics, clinical and histopathological characteristics, survival, and other post-surgical outcomes in patients with OTSCC treated with glossectomy through the department of Otolaryngology-Head & Neck Surgery (OTO-HNS) at University of Washington Medical Center (UWMC) within our study time period. Materials and Methods: A retrospective chart review was performed utilizing Leaf, a self-service tool provided through the Institute of Translational Health Sciences (University of Washington, Seattle, WA). Electronic medical records of eligible patients were analyzed for demographic, clinical, histopathological, and surgical variables. Patients were eligible for inclusion if treated with glossectomy, hemiglossectomy, or subtotal glossectomy at UWMC between January 1st, 2016 and December 31st, 2019. Patients were excluded if OTSCC involved other anatomic sites, if surgery required composite resection, or if surgery was performed to treat recurrent OTSCC. Additional information related to risk factors, presenting signs and symptoms, clinical and pathologic staging, and treatment outcomes were analyzed for a random subset of 30 patients. Results: Sixty patients with OTSCC met inclusion criteria. OTSCC was more common in men (58.3%; N=35) with mean age at 61.4 years (26 to 95 years). The great majority of patients were white (91.7%). Subset analysis found 60% of patients to be smokers with 73% having history of alcohol use. In 80% of these cases OTSCC involved the lateral border of the tongue with 53% involving left side. Clinical stage varied with 40% of patients with stage I disease (N=12), 20% stage II, 30% stage III, and 10% stage IV. Nearly 77% of patients were treated with partial glossectomy (N = 23), 3 with hemiglossectomy, and 4 with subtotal glossectomy. Approximately 50% of tumors were high grade (N = 15) with 43% low grade. Two specimens were negative for SCC on histopathologic analysis (6.7%). Twenty-three percent of specimens (N = 7) had positive resection margins. Neck dissection was performed in 63.3% of cases (N = 19) which identified positive lymph nodes in 36.7% of patients (N = 11). Perineural and lymphovascular invasion were common with 9 instances of each. Five patients (16.7%) were diagnosed with recurrent OTSCC (2 local and 3 locoregional) with 26.7% (N = 8) deceased during the same time frame. Survival rates in the entire cohort were similar at 21.7% (N = 13 out of 60). Five-year Kaplan-Meier overall survival probability for all patients was 0.42. Conclusions: The presence of prognostic factors for OTSCC like advanced clinical stage, high pathologic grade, greater depth of invasion, and presence lymph node metastasis, perineural invasion, and lymphovascular invasion has a negative impact on survival outcomes in patients who have undergone surgical treatment for OTSCC. These factors were common in patients who experienced recurrence and experienced death during our study follow-up period. Survival was greater in patients with earlier stage tumors highlighting the importance of early detection of OTSCC.application/pdfen-USnoneGlossectomyOral Squamous Cell CarcinomaStageSurgerySurvivalTongueDentistryOncologySurgeryDentistryThesis