Rak języka
Rokowania, prognozy i postęp choroby

Rokowanie pacjentów z rakiem języka jest determinowane przez szereg czynników klinicznych i patologicznych, z których najistotniejsze to stopień zaawansowania choroby (TNM), status węzłów chłonnych (pN), głębokość inwazji guza (DOI), inwazja okołonerwowa (PNI), inwazja naczyń limfatycznych i krwionośnych (LVI), stopień zróżnicowania histologicznego oraz marginesy chirurgiczne. Pięcioletnie przeżycie całkowite (OS) waha się od 42% do 84%, a przeżycie wolne od choroby (DFS) wynosi około 63-72%. Według danych SEER, pięcioletnie względne przeżycie dla raka języka wynosi 84-84,5% w stadium miejscowym, 69-70% w stadium regionalnym oraz 41-41,8% w stadium odległym. Obecność przerzutów do węzłów chłonnych oraz naciekanie pozatorebkowe (ENE) znacząco pogarszają rokowanie, podobnie jak głębokość inwazji ≥10 mm i inwazja okołonerwowa. Wczesne stadium choroby leczone chirurgicznie cechuje się nawrotami na poziomie około 26,6%, a pacjenci bez czynników ryzyka wykazują 5-letnie OS na poziomie 92,0% w porównaniu do 72,7% u pacjentów z co najmniej jednym czynnikiem ryzyka.

  1. Rak języka – Rokowanie (prognoza)
    1. Wskaźniki przeżycia
    2. Kliniczne czynniki prognostyczne
    3. Histopatologiczne czynniki prognostyczne
    4. Markery molekularne w prognozowaniu
    5. Modele prognostyczne
    6. Stratyfikacja ryzyka
    7. Znaczenie optymalizacji leczenia dla rokowania
    8. Podsumowanie czynników prognostycznych
    9. Kolejne rozdziały

Rak języka – Rokowanie (prognoza)

Rokowanie pacjentów z rakiem języka zależy od wielu czynników klinicznych i patologicznych. Dokładna ocena prognostyczna ma kluczowe znaczenie w planowaniu leczenia i określeniu potrzeby terapii adjuwantowej. Niniejszy artykuł omawia czynniki prognostyczne i wskaźniki przeżycia pacjentów z rakiem języka (rak języka), na podstawie aktualnych danych naukowych.12

Wskaźniki przeżycia

Wieloletnie badania dotyczące raka języka dostarczają danych na temat wskaźników przeżycia pacjentów. Pięcioletnie przeżycie całkowite (OS – overall survival) dla pacjentów z rakiem języka wynosi, w zależności od badań, od 42% do 84%. Jednocześnie pięcioletnie przeżycie wolne od choroby (DFS – disease-free survival) wynosi około 63-72%.123

Wskaźniki przeżycia różnią się znacząco w zależności od stopnia zaawansowania choroby w momencie rozpoznania. Według bazy danych SEER (Surveillance, Epidemiology, and End Results), pięcioletnie względne przeżycie dla raka języka wynosi:45

Stopień zaawansowania Pięcioletnie przeżycie względne
Miejscowy (Localized) 84-84,5%
Regionalny (Regional) 69-70%
Odległy (Distant) 41-41,8%
Wszystkie stopnie łącznie 69-69,7%

Należy zauważyć, że wskaźniki przeżycia są jedynie szacunkowym odzwierciedleniem danych historycznych i nie mogą dokładnie przewidzieć indywidualnego rokowania pacjenta. Ponadto, wraz z postępem metod leczniczych, obecni pacjenci mogą mieć lepsze rokowanie niż wynikałoby to z przedstawionych danych, które opierają się na pacjentach diagnozowanych i leczonych co najmniej 5 lat wcześniej.67

Kliniczne czynniki prognostyczne

Wśród najważniejszych klinicznych czynników prognostycznych w raku języka wyróżnia się:8910

  • Stopień zaawansowania choroby (TNM) – niższy stopień zaawansowania wiąże się z lepszym rokowaniem, a stopień zaawansowania choroby jest uznawany za najważniejszy czynnik prognostyczny związany z przeżyciem
  • Obecność przerzutów do węzłów chłonnych – status węzłów chłonnych szyi (pN) jest najistotniejszym predyktorem zarówno OS jak i DFS
  • Wielkość guza pierwotnego (T) – wyższy stopień T wiąże się z gorszym rokowaniem
  • Lokalizacja guza – rokowanie może zależeć od dokładnej lokalizacji nowotworu w obrębie języka
  • Wiek i ogólny stan zdrowia pacjenta – mogą wpływać na tolerancję leczenia i tym samym na rokowanie

111213

Histopatologiczne czynniki prognostyczne

Cechy histopatologiczne guza mają istotny wpływ na rokowanie pacjentów z rakiem języka. Najważniejsze z nich to:141516

  • Głębokość inwazji guza (DOI – depth of invasion) – guzy o głębokości inwazji ≥10 mm wiążą się z gorszym rokowaniem; niektóre badania wskazują na wartość graniczną 5 mm
  • Inwazja okołonerwowa (PNI – perineural invasion) – obecność inwazji okołonerwowej jest niezależnym czynnikiem związanym z gorszym DFS
  • Inwazja naczyń limfatycznych i krwionośnych (LVI – lymphovascular invasion) – zwiększa ryzyko rozsiewu ogólnoustrojowego i pogarsza rokowanie
  • Stopień zróżnicowania histologicznego – nowotwory średnio (G2) i nisko zróżnicowane (G3) wiążą się z gorszym rokowaniem
  • Marginesy chirurgiczne – ujemne marginesy chirurgiczne (R0) wiążą się z lepszym rokowaniem
  • Obecność naciekania pozatorebkowego (ENE – extranodal extension) – naciekanie poza torebkę węzła chłonnego pogarsza rokowanie

1718

Markery molekularne w prognozowaniu

Współczesne badania wskazują na rolę markerów molekularnych w prognozowaniu przebiegu raka języka. Do najważniejszych należą:1920

  • Ekspresja MVP (Major Vault Protein) – nadekspresja tego białka wiąże się z gorszym przeżyciem wolnym od choroby (DFS) i przeżyciem specyficznym dla przyczyny (CSS)
  • Ekspresja IGF-1R (Insulin-like Growth Factor 1 Receptor) – jednoczesna nadekspresja MVP i IGF-1R silnie koreluje z gorszym rokowaniem, szczególnie w zaawansowanych stadiach choroby (III-IV)
  • Profil ekspresji genów – opracowane sygnatury genowe, takie jak LNMsig i OSsig, mogą być pomocne w przewidywaniu przerzutów do węzłów chłonnych i całkowitego przeżycia

21

Modele prognostyczne

W celu indywidualizacji rokowania opracowano różne modele predykcyjne dla pacjentów z rakiem języka:2223

  • Model LGBM (Light Gradient Boosting Machine) – model uczenia maszynowego do przewidywania 5-letniego przeżycia całkowitego (OS) u pacjentów z rakiem języka, osiągający wartość AUC=0,860
  • Nomogramy kliniczne – opracowane do przewidywania OS i CSS u pacjentów z rakiem języka w IV stopniu zaawansowania po leczeniu chirurgicznym
  • Model predykcji przerzutów węzłowych – wykorzystujący kombinacje parametrów histopatologicznych do identyfikacji pacjentów z wyższym ryzykiem przerzutów węzłowych

24

Stratyfikacja ryzyka

Na podstawie czynników prognostycznych można dokonać stratyfikacji ryzyka pacjentów z rakiem języka. Badania wykazały, że pacjenci bez czynników ryzyka (nisko zróżnicowana histologia, głębokość inwazji >5 mm i inwazja okołonerwowa) mają znacząco lepsze OS (5-letnie wskaźniki 92,0% vs 72,7%) i LRFFS (przeżycie wolne od wznowy lokoregionalnej) (5-letnie wskaźniki 76,8% vs 66,6%) niż pacjenci z co najmniej jednym z tych czynników ryzyka.25

W przypadku raka języka we wczesnym stadium, leczonym wyłącznie chirurgicznie, ogólny wskaźnik nawrotów wynosi około 26,6%. Słabo zróżnicowana histologia, głębokość inwazji ≥5 mm oraz inwazja okołonerwowa są czynnikami ryzyka wpływającymi zarówno na OS, jak i LRFFS.26

Znaczenie optymalizacji leczenia dla rokowania

Optymalne leczenie ma kluczowe znaczenie dla poprawy rokowania pacjentów z rakiem języka. W przypadku zidentyfikowania niekorzystnych czynników prognostycznych, takich jak przerzuty do węzłów chłonnych szyi czy inwazja okołonerwowa, konieczne jest zastosowanie leczenia skojarzonego w celu poprawy OS i DFS.27

Chirurgia jest podstawowym elementem leczenia pacjentów z zaawansowanym rakiem języka, a pooperacyjna radioterapia lub chemioradioterapia powinna być rozważona w przypadku obecności niekorzystnych czynników. Dobór właściwej strategii leczenia, szczególnie w przypadku pacjentów wysokiego ryzyka, może istotnie poprawić rokowanie.28

Podsumowanie czynników prognostycznych

Rak języka charakteryzuje się zróżnicowanym rokowaniem zależnym od wielu czynników. Najważniejszymi czynnikami wpływającymi na rokowanie są:293031

  1. Status węzłów chłonnych (pN) – najsilniejszy predyktor zarówno OS jak i DFS
  2. Stopień zaawansowania TNM – szczególnie istotny dla całościowej oceny rokowania
  3. Inwazja okołonerwowa (PNI) – niezależny czynnik związany z gorszym DFS
  4. Głębokość inwazji guza (DOI) – guzy głębiej naciekające mają gorsze rokowanie
  5. Marginesy chirurgiczne – ujemne marginesy wiążą się z lepszym rokowaniem
  6. Stopień zróżnicowania histologicznego – guzy G2 i G3 mają gorsze rokowanie
  7. Inwazja naczyń limfatycznych i krwionośnych (LVI) – zwiększa ryzyko rozsiewu

Należy podkreślić, że rokowanie może się znacząco różnić w zależności od indywidualnego przypadku, a powyższe dane statystyczne stanowią jedynie ogólne wskazówki. Dokładna prognoza powinna być ustalana przez lekarza znającego pełną historię medyczną pacjenta, typ i stadium nowotworu oraz inne istotne cechy.3233

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

  1. 15.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Treatment outcomes and prognostic factors in oral tongue cancer: a 20-year retrospective study at the National Cancer Center, South Korea
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9433855/
    This study aimed to analyze the treatment outcomes and to evaluate the clinicopathological prognostic factors of oral tongue cancer. […] The 5-year overall survival (OS) and 5-year disease-free survival (DFS) were 72% and 63%, respectively. […] Multivariate analysis revealed that a positive neck nodal status (N1, N2-3) was significantly associated with poorer 5-year OS and DFS, while perineural invasion was associated with poorer 5-year DFS. […] Cervical metastasis and perineural invasion are significant prognostic predictors, and combination treatments are necessary for improving OS and DFS in patients with these factors. […] Our study of survival outcomes revealed 5-year OS and DFS of 72% and 63%, respectively. […] The univariate analysis revealed that the following factors were significantly associated with poor prognosis in terms of OS: increasingly positive pN stages (N1, N2-3); advanced-stage disease (III-IV); treatment modality (adjuvant RT or CRT, definitive RT/CRT); moderately (G2) to poorly differentiated (G3) tumors; depth of invasion (DOI) 10 mm; advanced T stage (T3-4); PNI, lymphovascular invasion (LVI), and ENE.
  • #2 Prognosis and survival for oral cancer | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/oral/prognosis-and-survival
    If you have oral cancer, you may have questions about your prognosis. A prognosis is the doctors best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis. […] The stage of oral cancer is an important prognostic factor. The lower the stage, the better the prognosis. […] Tumour thickness is also an important prognostic factor. A thin tumour has a better prognosis. A thicker tumour has a higher risk of coming back (recurring) in the same place (local recurrence). Thicker tumours are also more likely to have spread to the lymph nodes.
  • #2 Prediction of 5-year overall survival of tongue cancer based machine learning
    https://pmc.ncbi.nlm.nih.gov/articles/PMC10423415/
    We aimed to develop a 5-year overall survival prediction model for patients with oral tongue squamous cell carcinoma based on machine learning methods. […] The 5-year survival rate was 42%. […] The Light Gradient Boosting Machine prediction model predicted 5-year overall survival in OTSCC patients, and this predictive tool has potential prognostic implications for patients with OTSCC. […] The results showed that the 5-year overall survival of OTSCC patients was 42%. […] The LGBM prediction model had the maximum AUC value (AUC=0.860). This predictive tool has potential prognostic implications for patients with OTSCC.
  • #3 Survival outcome and prognostic factor analyses in early tongue cancer patients treated with surgery alone – Cheng – Therapeutic Radiology and Oncology
    https://tro.amegroups.org/article/view/5990/html
    The long-term outcome for early stage tongue cancer is generally good, however patients who suffered from local recurrence experienced a worse outcome than those who had not. […] The 5-year overall survival (OS) and locoregional failure-free survival (LRFFS) rates were 83.9% and 72.4%, respectively. […] Patients with an absence of any risk factors (poorly differentiated histology, invasion depth over 5 mm, and PNI) experienced significantly better OS (5-year rates, 92.0% vs. 72.7%, P=0.0001) and LRFFS (5-year rates, 76.8% vs. 66.6%, P=0.0382) than those with at least one of the risk factors. […] An overall relapse rate of 26.6% was observed for patients with early tongue cancer treated by surgery alone. […] A poorly differentiated histology, DOI 5 mm and PNI are the risk factors influencing both OS and LRRFS.
  • #4 Survival Rates for Oral Cavity and Oropharyngeal Cancer | American Cancer Society
    https://www.cancer.org/cancer/types/oral-cavity-and-oropharyngeal-cancer/detection-diagnosis-staging/survival-rates.html
    Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed. […] Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. […] The SEER database tracks 5-year relative survival rates for oral cavity and oropharyngeal cancers in the United States, based on how far the cancer has spread. […] These numbers are based on people diagnosed with cancers of the oral cavity (mouth) or oropharynx (the part of the throat behind the mouth) between 2012 and 2018. […] Tongue: Localized 84%, Regional 70%, Distant 41%, All SEER stages combined 69%.
  • #5 Tongue Cancer: Symptoms, Causes (Smoking, HPV) & Survival Rate
    https://www.cancercenter.com/cancer-types/oral-cancer/types/tongue-cancer
    Tongue cancer survival rates are indicators of how groups of patients in the past fared on average. In general, early diagnosis and treatment may lead to better outcomes. […] For tongue cancer, the NCI calculates the five-year relative survival rate as 84.5 percent for localized, 69.9 percent for regional and 40.8 percent for distant, with a combined rate of 69.7 percent for all stages. […] Keep in mind that the survival rate for tongue cancer depends on a variety of factors, including the patient’s age, overall health and the extent of disease, so always talk to the care team about the patient’s individual prognosis.
  • #6 Survival Rates for Oral Cavity and Oropharyngeal Cancer | American Cancer Society
    https://www.cancer.org/cancer/types/oral-cavity-and-oropharyngeal-cancer/detection-diagnosis-staging/survival-rates.html
    These numbers apply only to the stage of the cancer when it is first diagnosed. They do not apply later on if the cancer grows, spreads, or comes back after treatment. […] People now being diagnosed with oral cavity or oropharyngeal cancer may have a better outlook than these numbers show. Treatments improve over time, and these numbers are based on people who were diagnosed and treated at least 5 years earlier.
  • #7 Tongue Cancer: Symptoms, Causes (Smoking, HPV) & Survival Rate
    https://www.cancercenter.com/cancer-types/oral-cancer/types/tongue-cancer
    Tongue cancer survival rates are indicators of how groups of patients in the past fared on average. In general, early diagnosis and treatment may lead to better outcomes. […] For tongue cancer, the NCI calculates the five-year relative survival rate as 84.5 percent for localized, 69.9 percent for regional and 40.8 percent for distant, with a combined rate of 69.7 percent for all stages. […] Keep in mind that the survival rate for tongue cancer depends on a variety of factors, including the patient’s age, overall health and the extent of disease, so always talk to the care team about the patient’s individual prognosis.
  • #8 Treatment outcomes and prognostic factors in oral tongue cancer: a 20-year retrospective study at the National Cancer Center, South Korea
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9433855/
    This study aimed to analyze the treatment outcomes and to evaluate the clinicopathological prognostic factors of oral tongue cancer. […] The 5-year overall survival (OS) and 5-year disease-free survival (DFS) were 72% and 63%, respectively. […] Multivariate analysis revealed that a positive neck nodal status (N1, N2-3) was significantly associated with poorer 5-year OS and DFS, while perineural invasion was associated with poorer 5-year DFS. […] Cervical metastasis and perineural invasion are significant prognostic predictors, and combination treatments are necessary for improving OS and DFS in patients with these factors. […] Our study of survival outcomes revealed 5-year OS and DFS of 72% and 63%, respectively. […] The univariate analysis revealed that the following factors were significantly associated with poor prognosis in terms of OS: increasingly positive pN stages (N1, N2-3); advanced-stage disease (III-IV); treatment modality (adjuvant RT or CRT, definitive RT/CRT); moderately (G2) to poorly differentiated (G3) tumors; depth of invasion (DOI) 10 mm; advanced T stage (T3-4); PNI, lymphovascular invasion (LVI), and ENE.
  • #9 Prognosis and survival for oral cancer | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/oral/prognosis-and-survival
    If you have oral cancer, you may have questions about your prognosis. A prognosis is the doctors best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis. […] The stage of oral cancer is an important prognostic factor. The lower the stage, the better the prognosis. […] Tumour thickness is also an important prognostic factor. A thin tumour has a better prognosis. A thicker tumour has a higher risk of coming back (recurring) in the same place (local recurrence). Thicker tumours are also more likely to have spread to the lymph nodes.
  • #10 Prognosis and survival for oral cancer | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/oral/prognosis-and-survival
    Tumours with negative surgical margins have a better prognosis. […] When oral cancer has grown into, around or along a nerve (called perineural invasion) the prognosis may be poorer. […] When oral cancer has spread to blood vessels (called vascular invasion) it may increase the risk of spread throughout the body. Cancer that has spread throughout the body has a poorer prognosis. […] Oral cancer that has spread to the lymph nodes has a poorer prognosis. The more lymph nodes the cancer reaches, the higher the risk of distant spread or metastasis. If cancer grows beyond the wall of a lymph node (called extracapsular extension), the prognosis is also poorer. […] Prognosis can also depend on the location of the oral cancer. […] Survival will vary with each stage of oral cancer. It usually responds well to treatment.
  • #11 Treatment outcomes and prognostic factors in oral tongue cancer: a 20-year retrospective study at the National Cancer Center, South Korea
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9433855/
    This study aimed to analyze the treatment outcomes and to evaluate the clinicopathological prognostic factors of oral tongue cancer. […] The 5-year overall survival (OS) and 5-year disease-free survival (DFS) were 72% and 63%, respectively. […] Multivariate analysis revealed that a positive neck nodal status (N1, N2-3) was significantly associated with poorer 5-year OS and DFS, while perineural invasion was associated with poorer 5-year DFS. […] Cervical metastasis and perineural invasion are significant prognostic predictors, and combination treatments are necessary for improving OS and DFS in patients with these factors. […] Our study of survival outcomes revealed 5-year OS and DFS of 72% and 63%, respectively. […] The univariate analysis revealed that the following factors were significantly associated with poor prognosis in terms of OS: increasingly positive pN stages (N1, N2-3); advanced-stage disease (III-IV); treatment modality (adjuvant RT or CRT, definitive RT/CRT); moderately (G2) to poorly differentiated (G3) tumors; depth of invasion (DOI) 10 mm; advanced T stage (T3-4); PNI, lymphovascular invasion (LVI), and ENE.
  • #12
    https://link.springer.com/article/10.1186/1748-717X-7-147
    MVP expression was positive in 112 patients (85.5%) and no relation was found with clinic pathological variables. […] Tumour stage of the disease was the most important prognostic factor related to survival. […] Tumours overexpressing MVP and IGF-1R were strongly related to poor disease-free survival (P=0.008, Exp(B)=2.730, CI95% (1.302-5.724)) and cause-specific survival (P=0.014, Exp(B)=2.570, CI95% (1.215-5.437)) in patients achieving tumour stages III-IV, in multivariate analysis. […] MVP and IGF-1R expression were related in oral squamous cell carcinoma and conferred reduced long-term survival in patients suffering from advanced stages of the disease. […] Actuarial survival ratios after 15 years of follow-up in the whole series were 65.6, 70.2, 90.6, 49.6, and 57.1% for LDFS, RDFS, DMFS, DFS, and CSS, respectively.
  • #13
    https://link.springer.com/article/10.1186/1748-717X-7-147
    Because tumour stage was the most important prognostic factor for survival, we analyzed the role of MVP on long-term control and survival segmenting patients according to the pathological tumour stage. […] MVP overexpression was a predictive factor for DFS (P=0.016, Exp(B)=2.584, CI95% (1.191-5.604)) and CSS (P=0.011, Exp(B)=2.916, CI95% (1.286-6.629)) in multivariate analysis. […] Combination analysis was performed grouping MVP and IGF-1R expression in tumours. […] In multivariate analysis, MVP and IGF-1R overexpression was a predictive factor for DFS (P=0.008, Exp(B)=2.730, CI95% (1.302-5.724)) and CSS (P=0.014, Exp(B)=2.570, CI95% (1.215-5.437)). […] The present results could help to understand the biological behavior of this tumor type according to the expression not only of IGF-1R, but also of MVP.
  • #14 Treatment outcomes and prognostic factors in oral tongue cancer: a 20-year retrospective study at the National Cancer Center, South Korea
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9433855/
    This study aimed to analyze the treatment outcomes and to evaluate the clinicopathological prognostic factors of oral tongue cancer. […] The 5-year overall survival (OS) and 5-year disease-free survival (DFS) were 72% and 63%, respectively. […] Multivariate analysis revealed that a positive neck nodal status (N1, N2-3) was significantly associated with poorer 5-year OS and DFS, while perineural invasion was associated with poorer 5-year DFS. […] Cervical metastasis and perineural invasion are significant prognostic predictors, and combination treatments are necessary for improving OS and DFS in patients with these factors. […] Our study of survival outcomes revealed 5-year OS and DFS of 72% and 63%, respectively. […] The univariate analysis revealed that the following factors were significantly associated with poor prognosis in terms of OS: increasingly positive pN stages (N1, N2-3); advanced-stage disease (III-IV); treatment modality (adjuvant RT or CRT, definitive RT/CRT); moderately (G2) to poorly differentiated (G3) tumors; depth of invasion (DOI) 10 mm; advanced T stage (T3-4); PNI, lymphovascular invasion (LVI), and ENE.
  • #15 Treatment outcomes and prognostic factors in oral tongue cancer: a 20-year retrospective study at the National Cancer Center, South Korea
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9433855/
    Multivariate analysis also revealed that the pN status (N1, N2-3) was the most important predictor of both OS and DFS. […] The median duration of DFS was 25 months. The 5-year DFS was 63%. […] However, multivariate analysis revealed that pN1 (HR, 2.499; 95% CI, 1.148-5.442; P=0.021), pN2-3 (HR, 4.022; 95% CI, 2.124-7.614; P0.001), and PNI (HR, 2.145; 95% CI, 1.192-3.860; P=0.0109) exhibited significant negative effects on DFS. […] In conclusion, the univariate analyses in this study revealed that survival outcomes in OTSCC were affected by increasing T stage, pN status, ENE, moderately to poorly differentiated tumors, LVI, PNI, and marginal status.
  • #16 Prognosis and survival for oral cancer | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/oral/prognosis-and-survival
    If you have oral cancer, you may have questions about your prognosis. A prognosis is the doctors best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis. […] The stage of oral cancer is an important prognostic factor. The lower the stage, the better the prognosis. […] Tumour thickness is also an important prognostic factor. A thin tumour has a better prognosis. A thicker tumour has a higher risk of coming back (recurring) in the same place (local recurrence). Thicker tumours are also more likely to have spread to the lymph nodes.
  • #17 Prognosis and survival for oral cancer | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/oral/prognosis-and-survival
    Tumours with negative surgical margins have a better prognosis. […] When oral cancer has grown into, around or along a nerve (called perineural invasion) the prognosis may be poorer. […] When oral cancer has spread to blood vessels (called vascular invasion) it may increase the risk of spread throughout the body. Cancer that has spread throughout the body has a poorer prognosis. […] Oral cancer that has spread to the lymph nodes has a poorer prognosis. The more lymph nodes the cancer reaches, the higher the risk of distant spread or metastasis. If cancer grows beyond the wall of a lymph node (called extracapsular extension), the prognosis is also poorer. […] Prognosis can also depend on the location of the oral cancer. […] Survival will vary with each stage of oral cancer. It usually responds well to treatment.
  • #18 Survival outcome and prognostic factor analyses in early tongue cancer patients treated with surgery alone – Cheng – Therapeutic Radiology and Oncology
    https://tro.amegroups.org/article/view/5990/html
    The long-term outcome for early stage tongue cancer is generally good, however patients who suffered from local recurrence experienced a worse outcome than those who had not. […] The 5-year overall survival (OS) and locoregional failure-free survival (LRFFS) rates were 83.9% and 72.4%, respectively. […] Patients with an absence of any risk factors (poorly differentiated histology, invasion depth over 5 mm, and PNI) experienced significantly better OS (5-year rates, 92.0% vs. 72.7%, P=0.0001) and LRFFS (5-year rates, 76.8% vs. 66.6%, P=0.0382) than those with at least one of the risk factors. […] An overall relapse rate of 26.6% was observed for patients with early tongue cancer treated by surgery alone. […] A poorly differentiated histology, DOI 5 mm and PNI are the risk factors influencing both OS and LRRFS.
  • #19
    https://link.springer.com/article/10.1186/1748-717X-7-147
    MVP expression was positive in 112 patients (85.5%) and no relation was found with clinic pathological variables. […] Tumour stage of the disease was the most important prognostic factor related to survival. […] Tumours overexpressing MVP and IGF-1R were strongly related to poor disease-free survival (P=0.008, Exp(B)=2.730, CI95% (1.302-5.724)) and cause-specific survival (P=0.014, Exp(B)=2.570, CI95% (1.215-5.437)) in patients achieving tumour stages III-IV, in multivariate analysis. […] MVP and IGF-1R expression were related in oral squamous cell carcinoma and conferred reduced long-term survival in patients suffering from advanced stages of the disease. […] Actuarial survival ratios after 15 years of follow-up in the whole series were 65.6, 70.2, 90.6, 49.6, and 57.1% for LDFS, RDFS, DMFS, DFS, and CSS, respectively.
  • #20
    https://link.springer.com/article/10.1186/1748-717X-7-147
    Because tumour stage was the most important prognostic factor for survival, we analyzed the role of MVP on long-term control and survival segmenting patients according to the pathological tumour stage. […] MVP overexpression was a predictive factor for DFS (P=0.016, Exp(B)=2.584, CI95% (1.191-5.604)) and CSS (P=0.011, Exp(B)=2.916, CI95% (1.286-6.629)) in multivariate analysis. […] Combination analysis was performed grouping MVP and IGF-1R expression in tumours. […] In multivariate analysis, MVP and IGF-1R overexpression was a predictive factor for DFS (P=0.008, Exp(B)=2.730, CI95% (1.302-5.724)) and CSS (P=0.014, Exp(B)=2.570, CI95% (1.215-5.437)). […] The present results could help to understand the biological behavior of this tumor type according to the expression not only of IGF-1R, but also of MVP.
  • #21 Prognostic modeling of oral cancer by gene profiles and clinicopathological co-variables | Oncotarget
    https://www.oncotarget.com/article/19576/text/
    Accurate staging and outcome prediction is a major problem in clinical management of oral cancer patients, hampering high precision treatment and adjuvant therapy planning. […] The 5-years overall survival for OSCC is 60%, but ranges from 10 to 80% depending on the extent of the tumor at diagnosis, as defined by the TNM stage. […] The LNMsig with 22 genes predicted nodal metastatic disease with an NPV of 84% in clinical stages I and II. […] The OSsig could be used to personalize treatment. By itself, the OSsig predicted overall survival with an iAUC of 0.63, which is already promising compared to the iAUC of 0.51 of standard pTNM. […] These findings show that the prognostic value of the OSsig adds to established clinical and pathological prognostic variables.
  • #22 Prediction of 5-year overall survival of tongue cancer based machine learning
    https://pmc.ncbi.nlm.nih.gov/articles/PMC10423415/
    We aimed to develop a 5-year overall survival prediction model for patients with oral tongue squamous cell carcinoma based on machine learning methods. […] The 5-year survival rate was 42%. […] The Light Gradient Boosting Machine prediction model predicted 5-year overall survival in OTSCC patients, and this predictive tool has potential prognostic implications for patients with OTSCC. […] The results showed that the 5-year overall survival of OTSCC patients was 42%. […] The LGBM prediction model had the maximum AUC value (AUC=0.860). This predictive tool has potential prognostic implications for patients with OTSCC.
  • #23 A model to predict nodal metastasis in patients with oral squamous cell carcinoma | PLOS One
    https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0201755
    Difficulty in precise decision making on necessity of surgery is a major problem when managing oral squamous cell carcinomas (OSCCs) with clinically negative neck. […] The proposed model provides a way of using combinations of histopathological parameters to identify patients with higher risks of nodal metastasis for surgical management. […] The presence of cervical lymph node metastases is the most important prognostic factor for survival in patients with OSCC. […] We therefore aimed to evaluate the association between DOI, POI and occurrence of metastasis of OSCC from buccal mucosa and tongue. […] The final outcome of the model revealed that T4 tumours in the buccal mucosa that have POI type 3 and has a depth of invasion 4 mm are more likely to metastasize. […] The model showed that there is a high chance of nodal metastasis when there is a tumour on the tongue that has a POI of type 4 regardless of depth of invasion.
  • #24
    https://journals.lww.com/md-journal/fulltext/2019/06280/nomograms_to_predict_survival_of_stage_iv_tongue.79.aspx
    To develop clinical nomograms for prediction of overall survival (OS) and cancer-specific survival (CSS) in patients with stage IV tongue squamous cell carcinoma (TSCC) after surgery based on the Surveillance, Epidemiology, and End Results (SEER) program database. […] Age, race, marital status, tumor site, AJCC T/N/M status, and radiotherapy were recognized as independent prognostic factors associated with OS as well as CSS. […] The established nomograms in this study exhibited good accuracy and effectiveness to predict 3-year and 5-year probabilities of OS and CSS in resected stage IV TSCC patients. […] Surgery is an essential routine treatment for advanced TSCC patients, and postoperative radiotherapy or chemoradiotherapy should also be considered. […] The nomograms in our study are significant for decision-making by patients. […] In conclusion, we constructed and validated clinical nomogram models to predict OS and CSS in patients with stage IV TSCC after surgery based on the SEER database. It exhibited good accuracy and effectiveness to identify those with high risks of mortality.
  • #25 Survival outcome and prognostic factor analyses in early tongue cancer patients treated with surgery alone – Cheng – Therapeutic Radiology and Oncology
    https://tro.amegroups.org/article/view/5990/html
    The long-term outcome for early stage tongue cancer is generally good, however patients who suffered from local recurrence experienced a worse outcome than those who had not. […] The 5-year overall survival (OS) and locoregional failure-free survival (LRFFS) rates were 83.9% and 72.4%, respectively. […] Patients with an absence of any risk factors (poorly differentiated histology, invasion depth over 5 mm, and PNI) experienced significantly better OS (5-year rates, 92.0% vs. 72.7%, P=0.0001) and LRFFS (5-year rates, 76.8% vs. 66.6%, P=0.0382) than those with at least one of the risk factors. […] An overall relapse rate of 26.6% was observed for patients with early tongue cancer treated by surgery alone. […] A poorly differentiated histology, DOI 5 mm and PNI are the risk factors influencing both OS and LRRFS.
  • #26 Survival outcome and prognostic factor analyses in early tongue cancer patients treated with surgery alone – Cheng – Therapeutic Radiology and Oncology
    https://tro.amegroups.org/article/view/5990/html
    The long-term outcome for early stage tongue cancer is generally good, however patients who suffered from local recurrence experienced a worse outcome than those who had not. […] The 5-year overall survival (OS) and locoregional failure-free survival (LRFFS) rates were 83.9% and 72.4%, respectively. […] Patients with an absence of any risk factors (poorly differentiated histology, invasion depth over 5 mm, and PNI) experienced significantly better OS (5-year rates, 92.0% vs. 72.7%, P=0.0001) and LRFFS (5-year rates, 76.8% vs. 66.6%, P=0.0382) than those with at least one of the risk factors. […] An overall relapse rate of 26.6% was observed for patients with early tongue cancer treated by surgery alone. […] A poorly differentiated histology, DOI 5 mm and PNI are the risk factors influencing both OS and LRRFS.
  • #27 Treatment outcomes and prognostic factors in oral tongue cancer: a 20-year retrospective study at the National Cancer Center, South Korea
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9433855/
    This study aimed to analyze the treatment outcomes and to evaluate the clinicopathological prognostic factors of oral tongue cancer. […] The 5-year overall survival (OS) and 5-year disease-free survival (DFS) were 72% and 63%, respectively. […] Multivariate analysis revealed that a positive neck nodal status (N1, N2-3) was significantly associated with poorer 5-year OS and DFS, while perineural invasion was associated with poorer 5-year DFS. […] Cervical metastasis and perineural invasion are significant prognostic predictors, and combination treatments are necessary for improving OS and DFS in patients with these factors. […] Our study of survival outcomes revealed 5-year OS and DFS of 72% and 63%, respectively. […] The univariate analysis revealed that the following factors were significantly associated with poor prognosis in terms of OS: increasingly positive pN stages (N1, N2-3); advanced-stage disease (III-IV); treatment modality (adjuvant RT or CRT, definitive RT/CRT); moderately (G2) to poorly differentiated (G3) tumors; depth of invasion (DOI) 10 mm; advanced T stage (T3-4); PNI, lymphovascular invasion (LVI), and ENE.
  • #28
    https://journals.lww.com/md-journal/fulltext/2019/06280/nomograms_to_predict_survival_of_stage_iv_tongue.79.aspx
    To develop clinical nomograms for prediction of overall survival (OS) and cancer-specific survival (CSS) in patients with stage IV tongue squamous cell carcinoma (TSCC) after surgery based on the Surveillance, Epidemiology, and End Results (SEER) program database. […] Age, race, marital status, tumor site, AJCC T/N/M status, and radiotherapy were recognized as independent prognostic factors associated with OS as well as CSS. […] The established nomograms in this study exhibited good accuracy and effectiveness to predict 3-year and 5-year probabilities of OS and CSS in resected stage IV TSCC patients. […] Surgery is an essential routine treatment for advanced TSCC patients, and postoperative radiotherapy or chemoradiotherapy should also be considered. […] The nomograms in our study are significant for decision-making by patients. […] In conclusion, we constructed and validated clinical nomogram models to predict OS and CSS in patients with stage IV TSCC after surgery based on the SEER database. It exhibited good accuracy and effectiveness to identify those with high risks of mortality.
  • #29 Treatment outcomes and prognostic factors in oral tongue cancer: a 20-year retrospective study at the National Cancer Center, South Korea
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9433855/
    This study aimed to analyze the treatment outcomes and to evaluate the clinicopathological prognostic factors of oral tongue cancer. […] The 5-year overall survival (OS) and 5-year disease-free survival (DFS) were 72% and 63%, respectively. […] Multivariate analysis revealed that a positive neck nodal status (N1, N2-3) was significantly associated with poorer 5-year OS and DFS, while perineural invasion was associated with poorer 5-year DFS. […] Cervical metastasis and perineural invasion are significant prognostic predictors, and combination treatments are necessary for improving OS and DFS in patients with these factors. […] Our study of survival outcomes revealed 5-year OS and DFS of 72% and 63%, respectively. […] The univariate analysis revealed that the following factors were significantly associated with poor prognosis in terms of OS: increasingly positive pN stages (N1, N2-3); advanced-stage disease (III-IV); treatment modality (adjuvant RT or CRT, definitive RT/CRT); moderately (G2) to poorly differentiated (G3) tumors; depth of invasion (DOI) 10 mm; advanced T stage (T3-4); PNI, lymphovascular invasion (LVI), and ENE.
  • #30 Prognosis and survival for oral cancer | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/oral/prognosis-and-survival
    If you have oral cancer, you may have questions about your prognosis. A prognosis is the doctors best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis. […] The stage of oral cancer is an important prognostic factor. The lower the stage, the better the prognosis. […] Tumour thickness is also an important prognostic factor. A thin tumour has a better prognosis. A thicker tumour has a higher risk of coming back (recurring) in the same place (local recurrence). Thicker tumours are also more likely to have spread to the lymph nodes.
  • #31
    https://link.springer.com/article/10.1186/1748-717X-7-147
    MVP expression was positive in 112 patients (85.5%) and no relation was found with clinic pathological variables. […] Tumour stage of the disease was the most important prognostic factor related to survival. […] Tumours overexpressing MVP and IGF-1R were strongly related to poor disease-free survival (P=0.008, Exp(B)=2.730, CI95% (1.302-5.724)) and cause-specific survival (P=0.014, Exp(B)=2.570, CI95% (1.215-5.437)) in patients achieving tumour stages III-IV, in multivariate analysis. […] MVP and IGF-1R expression were related in oral squamous cell carcinoma and conferred reduced long-term survival in patients suffering from advanced stages of the disease. […] Actuarial survival ratios after 15 years of follow-up in the whole series were 65.6, 70.2, 90.6, 49.6, and 57.1% for LDFS, RDFS, DMFS, DFS, and CSS, respectively.
  • #32 Prognosis and survival for oral cancer | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/oral/prognosis-and-survival
    If you have oral cancer, you may have questions about your prognosis. A prognosis is the doctors best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis. […] The stage of oral cancer is an important prognostic factor. The lower the stage, the better the prognosis. […] Tumour thickness is also an important prognostic factor. A thin tumour has a better prognosis. A thicker tumour has a higher risk of coming back (recurring) in the same place (local recurrence). Thicker tumours are also more likely to have spread to the lymph nodes.
  • #33 Tongue Cancer: Symptoms, Causes (Smoking, HPV) & Survival Rate
    https://www.cancercenter.com/cancer-types/oral-cancer/types/tongue-cancer
    Tongue cancer survival rates are indicators of how groups of patients in the past fared on average. In general, early diagnosis and treatment may lead to better outcomes. […] For tongue cancer, the NCI calculates the five-year relative survival rate as 84.5 percent for localized, 69.9 percent for regional and 40.8 percent for distant, with a combined rate of 69.7 percent for all stages. […] Keep in mind that the survival rate for tongue cancer depends on a variety of factors, including the patient’s age, overall health and the extent of disease, so always talk to the care team about the patient’s individual prognosis.

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