Objective: To evaluate the results of primary surgical treatment of carcinoma of oral tongue in Hong Kong.
Methods: Patients who had undergone primary surgical treatment of oral tongue carcinoma in Queen Mary Hospital were reviewed.
Results: There were 112 patients in this study. The first sites of tumor recurrence were 10 (9%) local, 25 (22%) nodal, 3 (3%) locoregional, 5 (5%) distant, 1 (1%) local and distant, 3 (3%) nodal and distant, and 1 (1%) neck extranodal site. Of the 63 T1-2 N0 M0 patients, the regional recurrence rate was 9% for elective neck dissection compared with 47% for "watchful waiting" (Chi-square test, P = 0.0008). The regional recurrence related mortality was 3% for elective neck dissection compared with 23% for "watchful waiting" (Fisher's test, P = 0.02). The 5-year actuarial survival rate was 86% for elective neck dissection compared with 55% for "watchful waiting" (Wilcoxon, P = 0.01).
Conclusions: Local and regional recurrences were the main sites of treatment failure. Elective neck dissection has significant benefits in the reduction of regional failure and improvement of survival. Elective selective I-III neck dissection have to be considered in patients with stage I and stage II oral tongue carcinoma.