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

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.

• Authors: Anil K D'Cruz, Ravichand C Siddachari, Rohan R Walvekar, Gouri H Pantvaidya, Devendra A Chaukar, Mandar S Deshpande, Prathamesh S Pai, Pankaj Chaturvedi
• Journal: Head & neck (Head Neck) Vol. 31 Issue 5 Pg. 618-24 (May 2009) ISSN: 1097-0347 [Electronic] United States
• PMID: 19132717 (Publication Type: Comparative Study, Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Squamous Cell (mortality, pathology, 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, pathology, therapy)