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Keywords:

  • randomized;
  • tongue;
  • carcinoma;
  • neck;
  • dissection

Abstract

Background.

There are controversies on the benefits of elective neck dissection (END) for oral tongue carcinoma.

Method.

This is a prospective randomized study of elective selective I, II, III neck dissection versus observation for N0 neck of stage I to II oral tongue carcinoma. There were 35 patients on the observation arm and 36 patients on the END arm. The main outcome assessment parameters are node-related mortality and disease-specific survival rate.

Results.

There were 11 patients in the observed arm and 2 patients in the END arm who developed nodal recurrence alone without associated local or distant recurrence. All 13 patients were salvaged, and no patient died of nodal recurrence. The 5-year disease-specific survival rate was 87% for the observation arm and was 89% for the END arm; the 2% difference was not significant.

Conclusion.

Observation may be an acceptable alternative to END if strict adherence to a cancer surveillance protocol is followed. © 2009 Wiley Periodicals, Inc. Head Neck, 2009