Does elective neck dissection in T1/T2 carcinoma of the oral tongue and floor of the mouth influence recurrence and survival rates?

• Published in: British journal of oral & maxillofacial surgery Vol. 52; no. 7; pp. 590 - 597
• Main Authors: Kelner, Natalie, Vartanian, José Guilherme, Pinto, Clóvis Antônio Lopes, Coutinho-Camillo, Cláudia Malheiros, Kowalski, Luiz Paulo
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.09.2014
• Subjects: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - secondary; Carcinoma, Squamous Cell - surgery; Dentistry; Disease-Free Survival; Early stage; Elective neck dissection; Elective Surgical Procedures; Female; Follow-Up Studies; Humans; Lymph nodes; Lymphatic Metastasis - diagnosis; Male; Middle Aged; Mouth Floor - pathology; Mouth Floor - surgery; Mouth Neoplasms - pathology; Mouth Neoplasms - surgery; Neck Dissection - methods; Neoplasm Grading; Neoplasm Invasiveness; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; Oral cancer; Radiotherapy, Adjuvant; Reconstructive Surgical Procedures - methods; Salvage Therapy - methods; Squamous cell carcinoma; Surgery; Survival Rate; Tongue Neoplasms - pathology; Tongue Neoplasms - surgery; Watchful Waiting; Young Adult; Early stage; Squamous cell carcinoma; Elective neck dissection; Oral cancer; Lymph nodes
• ISSN: 0266-4356; 1532-1940
• DOI: 10.1016/j.bjoms.2014.03.020

Abstract The aim of this study was to evaluate the results of elective neck dissection compared with observation (control group) in selected cases of early carcinoma of the oral tongue and floor of the mouth. It was a retrospective analysis of 222 patients who had the tumour resected (161 also had elective neck dissection). Occult lymph node metastases were detected in 33/161 (21%), and neck recurrences were diagnosed in 10 of the 61 patients in the control group (16%). Occult lymph node metastases reduced the 5-year disease-specific survival from 90% to 65% ( p = 0.001) and it was 96% among the controls. The 5-year disease-specific survival was 85% in the group treated by neck dissection and 96% in the observation group ( p = 0.09). Rigorous follow-up of selected low risk patients is associated with high rates of salvage, and overall survival was similar to the observed survival in patients treated by elective neck dissection. Observation is a reasonable option in the treatment of selected patients.