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Transhyoid Approach for Tongue Base Cancer

Objective: Cancer of the base of the tongue presents much less frequently than cancer of the mobile part of the tongue. Squamous cell carcinomas at the base of the tongue are usually diagnosed in advanced stages, and the optimal treatment has not been established. Method: Retrospective study from 1998 to 2007. A base of the tongue transhyoid resection was performed in 37 previously untreated patients. Epiglotectomy or horizontal supraglottic laryngectomy was also included in 14 cases (37.83%) and in 23 cases (62.17%). Bilateral neck dissections were performed in all cases. All of these patients underwent postoperative radiotherapy. Results: The postoperative and posttherapeutic evolution in 37 patients was favorable at 3 years (81.10%) and 5 years (75.67%), without signs of locoregional reccurences. The tumor-specific 3- and 5-year survival rates were: pT2 100%, pT3 87.5%, pT4a 71.42% and 57.14%, and pT4b 50%, respectively 25%. The stage-specific 3- and 5-year survival rates were: stage II 100%, stage III 85.71%, stage IVA 83.33%, and 79.16%, and stage IVB 50% and 25%, respectively. Conclusion: While the prognosis for squamous cell carcinomas of the base of the tongue is poor, especially in advanced stages, cancer resection using the transhyoid approach is a feasible procedure which permits excellent tumor control over a long period of time with limited postoperative morbidity.