Elective neck dissection versus observation in the management of early tongue carcinoma with clinically node-negative neck: a retrospective study of 229 cases.

BACKGROUND

The aim of the study is to evaluate the results of elective neck dissection (END) versus conservative management (observation) in the treatment of stages I and II squamous cell carcinoma of tongue.

PATIENTS AND METHODS

This is a retrospective study including 229 patients with surgical treatment between June 1993 and May 2010.

RESULTS

There were 15 (9.6%) patients in the END group and 14 (19.2%) patients in the observation group who developed nodal recurrence alone without associated local recurrence or distant metastasis. Node-related mortality rate was 5.1% (8/156) for END and 12.3% (9/73) for observation. Further analysis for subgroups of stage T1 showed that the patients from END group had a better 5-year disease-specific survival (DSS) than those from the observation group in spite of no statistical difference (87.2% vs. 76.0%, Log-rank p = 0.282). END compared with observation for patients with stage T2 had a better 5-year DSS (74.2% vs. 41.2%, Log-rank p = 0.008).

CONCLUSIONS

Elective neck dissection significantly reduces mortality due to lymph nodal metastasis and also increases the 5-year DSS, most marked in patients with stage T2 OSCC. This retrospective study suggests that END should be a preferred treatment strategy for tongue carcinoma in stage T2.