THE NATIONAL CANCER DATA BASE REPORT ON SQUAMOUS CELL CARCINOMA OF THE BASE OF TONGUE Weining Zhen, MD, 1 Lucy H. Karnell, PhD, 2 Henry T. Hoffman, MD, 2 Gerry F. Funk, MD, 2 John M. Buatti, MD, 3 Herman R. Menck, MBA 4 1 Department of Radiation Oncology and Department of Otolaryngology-Head and Neck Surgery, University of Nebraska Medical Center, 987521 Nebraska Medical Center, Omaha, Nebraska 68198-7521 2 Department of Otolaryngology—Head and Neck Surgery, University of Iowa Health Care, 200 Hawkins Drive, Iowa City, Iowa 52242. E-mail: lucy-karnell@uiowa.edu 3 Department of Radiation Oncology, University of Iowa Health Care, 200 Hawkins Drive, Iowa City, Iowa 52242 4 Cancer Surveillance Program of Los Angeles County, USC School of Medicine, Los Angeles, California Accepted 9 January 2004 Published online 20 May 2004 in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/hed.20064 Abstract: Background. This study provides the largest con- temporary overview of presentation, care, and outcome for base of tongue squamous cell carcinoma (SCC). Methods. We extracted 16,188 cases from the National Cancer Data Base (NCDB). Chi-square analyses were per- formed on selected cross-tabulations. Observed and disease- specific survival were used to analyze outcome. Results. Three-quarters had advanced-stage (III – IV) dis- ease. Radiation therapy alone (24.5%) and combined with sur- gery (26.9%) were the most common treatments. Five-year observed and disease-specific survival rates were 27.8% and 40.3%, respectively. Poorer survival was significantly asso- ciated with older age, low income, and advanced-stage disease. For early-stage disease, surgery with or without irradiation had higher survival than irradiation alone. For advanced-stage dis- ease, surgery with irradiation had the highest survival. Conclusions. Survival rates were low for base of tongue SCC, with most deaths occurring within the first 2 years. In- come, stage, and age were significant prognostic factors. In this nonrandomized series, surgery with radiation therapy of- fered patients with advanced-stage disease the best survival. A 2004 Wiley Periodicals, Inc. Head Neck 26: 660 – 674, 2004 Keywords: squamous cell carcinoma; SCC; base of tongue; disease characteristics; patterns of care; outcome; National Cancer Data Base (NCDB) Squamous cell carcinoma (SCC) of the tongue is one of the most common malignancies of the head and neck, with one third of these tumors arising in the base of the tongue. 1–6 The tongue base is defined as the tissue posterior to the circumvallate papillae, extending inferiorly to the vallecula and encompassing the lingual tonsils and the pharyn- goepiglottic and glossoepiglottic folds. Laterally, it extends to the glossopalatine sulcus. For large Correspondence to: Lucy Hynds Karnell From the Commission on Cancer at the American College of Surgeons, Chicago, Illinois, and the American Cancer Society, Atlanta, Georgia Reprint requests to: Weining Zhen, Department of Radiation Oncology and Department of Otolaryngology—Head and Neck Surgery, University of Nebraska Medical Center, 987521 Nebraska Medical Center, Omaha, NE 68198-7521. B 2004 Wiley Periodicals, Inc. HEAD & NECK August 2004 660 Base of Tongue Squamous Cell Carcinoma