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Prospective trial to evaluate staged neck dissection or elective neck radiotherapy in patients with CT‐staged T1‐2 N0 squamous cell carcinoma of the oral tongue
Author(s) -
Brennan Sinead,
Corry June,
Kleid Stephen,
Porceddu Sandro,
Yuen Kally,
Rischin Danny,
Peters Lester J.
Publication year - 2010
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.21167
Subject(s) - medicine , neck dissection , tongue , perineural invasion , radiation therapy , prospective cohort study , surgery , resection margin , carcinoma , lymphovascular invasion , survival rate , radiology , cancer , metastasis , resection , pathology
Background A prospective study was undertaken to evaluate a policy of selective, single‐modality elective neck treatment in T1‐2, node‐negative oral tongue squamous cell carcinoma. Methods Where the primary tumor showed 1 of the 4 key pathological criteria (greater than 7 mm of muscle invasion, less than 5 mm of resection margin, perineural or lymphovascular invasion), radiotherapy was delivered to the primary site and the at‐risk undissected neck. Otherwise patients underwent ipsilateral neck dissection within 4 weeks of initial resection. Prospective quality of life assessments were performed. Results The study was closed after accrual of 25 patients, because the high locoregional recurrence rate met early stopping criteria. With a median follow‐up of 3.4 years, the locoregional recurrence rate was 23%. The 4‐year overall and disease‐free survival rates were 71% and 64%, respectively. Conclusion The poor disease‐free survival reflects the need for better prognostic markers and more aggressive treatment in these patients. © 2009 Wiley Periodicals, Inc. Head Neck, 2010