Surgical treatment of stage I and II oral squamous cell carcinomas: analysis of causes of failure.

Sixty-one patients with stage I and II squamous cell carcinomas of the oral cavity treated by surgery alone were analysed to investigate treatment outcome, pattern of failure, and occurrence of second malignant neoplasms. The disease recurred or developed lately in 11 patients. The ipsilateral neck was the most common site of failure. Salvage treatment was successful in only three of these patients. Occult neck metastasis was found in 31% of patients with T2 tumours. Second malignant neoplasms developed in 20 patients and were the cause of death in 8 patients. In conclusion, locoregional control of stage I and II oral carcinomas is achieved by surgery alone. Elective neck dissection is required for patients with stage II tumours, showing a high risk of lymph node metastasis in histology.