Prospective randomized study of selective neck dissection versus observation for N0 neck of early tongue carcinoma

Head Neck. 2009 Jun;31(6):765-72. doi: 10.1002/hed.21033.

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.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Carcinoma, Squamous Cell / therapy
  • Chi-Square Distribution
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Monitoring, Physiologic / methods
  • Neck Dissection / methods*
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Observation / methods*
  • Patient Selection
  • Prospective Studies
  • Reference Values
  • Risk Assessment
  • Survival Analysis
  • Tongue Neoplasms / mortality*
  • Tongue Neoplasms / pathology
  • Tongue Neoplasms / surgery*
  • Tongue Neoplasms / therapy
  • Treatment Outcome