Neck Dissection for T1 Oral Tongue SCCA: The UCLA Experience

Abstract

Objective: The study was carried out in order to 1) evaluate features that could identify patients having increased risks of regional recurrences, and 2) examine the prognostic and therapeutic implications of elective neck dissection among patients who presented with early-stage oral tongue squamous cell carcinoma with clinically negative neck (T1cN0). Method: A retrospective chart review of oral tongue cancer at a single tertiary institution identified 123 patients with T1cN0 oral tongue squamous cell carcinoma who underwent surgical tumor extirpation with/without adjuvant radiation treatment and/or chemotherapy from 1990 through 2009. This database was used to identify characteristics that are associated with occult lymph node metastases and measurement of patient outcomes. Results: Eighty-nine patients underwent elective neck dissection, of which 20 patient specimens (22%) were found to harbor occult metastatic disease. However, no significant differences were noted in the frequency of regional recurrence according to gender, age, tumor size, the presence of perineural invasion, or occult metastatic disease ( P = .70, .29, .54, .30, and .47, respectively). In addition, patients who underwent elective neck dissection experienced lower rate of regional recurrence, although this did not achieve a statistically significant level ( P = .52). Conclusion: Clinical observation of the clinically negative neck is justifiable for early stage T1 oral tongue squamous cell carcinoma. Elective cervical lymphadenectomy offers no benefit in preventing regional recurrence when compared to clinical observation. Furthermore, neither patient factors nor intrinsic tumor features demonstrated any prognostic significance in the setting of early stage T1 oral tongue carcinoma.