Open AccessNeck Dissection for T1 Oral Tongue SCCA: The UCLA Experience
Author(s) -
Chu Alan C.,
Peng Kevin A.,
Kim Brandon,
Lai Chi,
Elashoff David,
Abemayor Elliot,
St. John Maie
Publication year - 2012
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599812451438a82
Subject(s) - medicine , tongue , neck dissection , occult , stage (stratigraphy) , surgery , t stage , cancer , perineural invasion , epidermoid carcinoma , radiation therapy , radiology , lymph node , carcinoma , tongue neoplasm , pathology , paleontology , alternative medicine , biology
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.