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. (C) 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.