Southern Iran tertiary-center validation of 5-year disease free survival and overall survival rates in tongue squamous cell carcinoma: a confirmatory retrospective 10-years cohort study

Squamous cell carcinoma (SCC) of the tongue is a particularly aggressive malignancy within the oral cavity, associated with significant morbidity and mortality. Although various prognostic factors have been studied globally, population-specific insights remain limited, particularly in Western Asia. This study aimed to identify survival predictors among Southern Iranian patients diagnosed with tongue SCC at a high-volume tertiary referral center in southern Iran. A retrospective cohort study was conducted involving 184 patients with histologically confirmed SCC of the tongue, treated between 2013 and 2023. Clinical, demographic, and pathological data were extracted from medical records. Disease-free survival (DFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Cox proportional hazards regression was utilized to identify independent prognostic factors. The cohort consisted of 54.3% females and 45.7% males, with a median age of 60 years (range 23–85). After a median follow-up of 61 months (range 29–93) for surviving patients, 75 were alive and disease-free, 14 were alive with disease, and 105 died from tongue cancer, representing all recorded deaths in the cohort. Univariate analysis revealed that advanced age (≥ 60 years), heart disease, advanced tumor stage (T3-T4), advanced nodal stage (N2-N3), advanced disease stage (III-IV), and positive surgical margins significantly correlated with reduced DFS and OS. Multivariate analysis identified older age, heart disease, and advanced tumor and nodal stage as independent predictors of decreased DFS and/or OS. The 5-year DFS and OS rates across the cohort were 31.0% and 40.3%, respectively. This retrospective cohort of 184 tongue SCC patients from Southern Iran demonstrated 5-year DFS and OS rates of 31.0% and 40.3%. Independent prognostic factors included advanced age, overall stage, positive surgical margins for DFS, and age, T-stage, and heart disease for OS. Interpretation of T-stage requires caution due to methodological heterogeneity across AJCC 7th and 8th editions. These region-specific findings underscore the need for prospective studies to refine personalized management.