Treatment of stage I and II oral tongue cancer

Authors

  • Dr. Daniel D. Lydiatt DDS, MD,

    Corresponding author
    1. Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
    • Department of Otolaryngology, University of Nebraska Medical Center, 600 South 42nd Street, Omaha, NE 68198-1225
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  • Dr. K. Thomas Robbins MD,

    1. Department of Head and Neck Surgery, University of California, San Diego Cancer Center, San Diego, California
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  • Dr. Robert M. Byers MD,

    1. Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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  • Dr. Patricia F. Wolf BS

    1. Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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Abstract

We reviewed 156 previously untreated patients with squamous cell carcinoma of the oral tongue staged T1 and T2 to determine the incidence of nodal metastasis, and if elective neck dissection affected local/regional control or survival. Patients were divided into two nonrandomized groups: group 1, intraoral glossectomy only (102 patients); and group 2, intraoral glossectomy plus neck dissection (54 patients). Analysis revealed no significant differences for tumor location, histologic differentiation, status of margins, or clinical appearance; however, perineural invasion significantly adversely affected survival and local/regional control. In group 1 patients, 16.5% subsequently developed cervical metastasis, and 20.4% of patients in group 2 had occult nodal disease. The survival and local/regional control for group 1 patients subsequently developing nodes was 33% and 50%, respectively. The survival and local/regional control for group 2 patients with occult metastasis was 55% and 91%, respectively. We believe elective neck dissection is indicated for early staged oral tongue cancer.

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