Elective neck dissection for the management of the N0 neck in early cancer of the oral tongue: need for a randomized controlled trial

Head Neck. 2009 May;31(5):618-24. doi: 10.1002/hed.20988.

Abstract

Background: The aim of this study is to determine the need for a randomized controlled trial in order to define the role of an elective neck dissection (END) in the treatment of early tongue cancers.

Methods: We present a large retrospective analysis of patients with T1-2 N0 squamous cell cancers of the oral anterior tongue treated at a single institution. A total of 359 eligible patients with early tongue cancers were divided into 2 groups: END and wait and watch (WW). An analysis for survival outcomes and prognostic factors was conducted.

Results: The estimated 3- and 5-year disease-free survival for the END group was 76% and 74% versus 71% and 68% for the WW group, respectively (p = .53). The 3- and 5-year overall survival (OS) rate for the END group was 69% and 60% versus 62% and 60% for the WW group, respectively (p = .24). Tumor grade and perineural invasion were independent predictors of recurrence.

Conclusion: END did not impact disease-free or OS. Current literature still remains divided on this issue emphasizing the need for a randomized controlled trial.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy*
  • Decision Making
  • Elective Surgical Procedures*
  • Female
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neck Dissection*
  • Neoplasm Recurrence, Local
  • Prognosis
  • Radiotherapy, Adjuvant
  • Randomized Controlled Trials as Topic
  • Retrospective Studies
  • Survival Analysis
  • Tongue Neoplasms / mortality
  • Tongue Neoplasms / pathology
  • Tongue Neoplasms / therapy*