Elective neck treatment versus observation in patients with T1/T2 N0 squamous cell carcinoma of oral tongue

Risk factors in oral carcinoma and the relationship between tumor thickness and regional nodal involvement: a pilot study in a semi urban population in New Delhi, India

“…11 The incidence of occult lymph-node metastasis in earlystage tumors (primary site T-categorization T1 or T2) has been reported to be between 27%-40%. 12 Also, generally speaking, elective neck dissection (END) is advocated in cases of oral carcinoma when the risk of cervical lymphnode involvement is greater than 15%-20%. 13 Therefore, in any surgical practice there will always be a significant number of patients who having undergone elective neck dissection and will suffer the morbidity of a neck dissection but will be free of nodal metastases.…”

A meta-analysis of the randomized controlled trials on elective neck dissection versus therapeutic neck dissection in oral cavity cancers with clinically node-negative neck

“…groups [40,46,157,169]. However, there have been few studies which showed a significant survival benefit in favor of elective neck dissection in oral carcinoma patients with clinically N0 neck [36,62,76,94,170]. Among prospective randomized trials, only the study by Kligerman et al showed evidence of a statistically significant disease-free survival benefit of elective neck dissection over a policy of observation [79] (Table 5 and Figure 4).…”

“…The patients whose necks were observed tended to have more regional recurrences [40,138] and the results of the salvage treatment of the neck were generally poor [37,40,46,76,81]. Nodal metastasis has been considered a significant prognostic factor in oral cavity cancers and other head and neck malignancies [6,13,118,135].…”

“…They however suggested concurrent neck treatment with the surgical extirpation of the primary tumor if the tumor depth is more than 4mm or if the patient cannot be regularly followed-up. However, a few retrospective studies have reported on the survival benefit of elective neck dissection in oral carcinoma with clinical N0 neck [37,62,76,94]. It has also been reported that the survival rate of patients with oral carcinomas will reduce by 50% once there is a palpable cervical lymph node [42,52,87,132].…”

Initial CT findings in early tongue and oral floor cancer as predictors of late neck metastasis

“…Early tongue and oral floor cancer is known for its propensity for subclinical lymph node metastasis, and the incidence of late neck metastasis has been reported at 20-30% 2,3,4 . It has been reported 5,6 that patients with neck lymph node metastasis tend to develop distant metastasis, even though the regional control is maintained by neck dissection.…”