Elective Neck Dissection for Management of Early-stage Oral Tongue Cancer

Document Type : Research Articles


1 Department of Surgical Oncology, National Cancer Institute, Cairo University, Egypt.

2 Department of Surgical Oncology, Faculty of Medicine, Alexandria University, Egypt.


Background: The occult neck metastasis rate is very high with tongue cancers. The aim of this study was to assess
the current role of elective neck dissection (END) in management of early-stage oral tongue cancer with a focus on
lymph node metastasis. In addition, effects of END on regional or systemic disease recurrence and survival were
investigated. Methods: This retrospective study included patients with stage I and II tongue cancer recruited from
our National Cancer Institute (NCI) over a time period of six years (2007-2013). The collected data were analyzed for
disease free survival (DFS) and recurrence rate. Results: A total of 144 patients presented to our NCI with oral tongue
cancer but only 88 were staged clinically and radiologically as early stage (stage I, stage II). Some 53% were smokers.
Most lesions were dealt with by surgery, either by wide local excision (22%) or hemiglossectomy (78%). Treatment of
neck lesions was either by neck dissection (85.2%) or “wait and see” (14.8%). The rates for local and nodal recurrence
were 7.9% and 20.4%, respectively. Analysis of associations between DFS and different factors revealed significance
for adoption of adjuvant therapy and the dissected lymph node status. Conclusion: Controversy still exists regarding
neck management.


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