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

Yuen, Andrea; Ho, Chiu M.; Chow, Tam‐Lin; Tang, Lap Chiu; Cheung, W.Y.; Ng, Raymond W. M.; Wei, William I.; Kong, Chi Kwan; Book, Kwok Shing; Yuen, Wai–Cheung; Lam, Alfred King‐Yin; Yuen, Nancy; Trendell-Smith, Nigel J.; Chan, Yap-Hang; Wong, Birgitta Yee-Hang; Li, George Kam-Hop; Ho, Ambrose Chung–Wai; Ho, Wai Kuen; Wong, Sau Yan; Yao, Tzy‐Jyun

doi:10.1002/hed.21033

Cited by 217 publications

(205 citation statements)

References 13 publications

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“…They had a robust follow-up protocol of clinical and ultrasonographic examination of the neck to detect recurrences. They were able to salvage all neck recurrences in the observational arm and thus found no survival differences between the two arms [3]. All the above RCTs had small numbers and consisted of methodology flaws making their conclusions difficult to inculcate into clinical practice.…”

Section: Discussionmentioning

confidence: 99%

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To Operate or Not to Operate N0 Neck in Early Cancer of the Tongue? A Prospective Study

Vijayakumar

Burrah

Sabitha

et al. 2011

Indian J Surg Oncol

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Squamous cell carcinoma (SCC) of the tongue is a common cancer across the globe. These cancers have a high predilection for nodal metastasis and a high incidence of occult metastasis. The management of clinically negative neck nodes (N0) remains controversial. We have undertaken a prospective study to evaluate the rate of occult nodal metastasis, the characteristic of metastasis, and assess the usefulness of tumor depth as a predictor of metastasis and as a guide to treat the neck. Prospective study between January 2000 to December 2005. Patients with SCC of the anterior 2/3rd of tongue with N0 neck were included. Wide excision of the primary and subsequent modified radical neck dissection (in patients with tumor depth>4 mm) was performed. Postoperative radiotherapy was given in patients with lymph node metastasis. Patients who had no node metastasis (p N -ve) were observed. The total number of eligible patients was 180. Occult lymph node metastasis (p N +ve) was seen in 122 (62.2%) patients (p<0.001), multiple levels of node involvement in 79 (70.5%) patients and extracapsular spread (ECS) in 38 (33.6%) patients. Patients in the p N +ve group who were disease free was 63.1% as compared to 68.2% in the p N -ve group (p=0.36). Recurrence was seen in 28 (36.8%) patients of p N +ve group and 14 (31.8%) patients of p N -ve group. Early cancer of tongue with tumor depth >4 mm was associated with predominantly high grade tumors, high incidence of occult nodal metastasis, multiple levels of nodal involvement and ECS. The disease free status of patients with occult metastasis who were treated was similar to that of patients with no nodal metastasis. Elective neck dissection appears essential for early oral tongue cancer with tumor depth >4 mm as there is no investigational modality which can reliably identify patients without occult metastasis.

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Section: Discussionmentioning

confidence: 99%

“…To date four randomized control trials (RCT) have been conducted to address this issue. Two of these included only cancer of the tongue [2,3] and the other two [4,5] have included other early cancers of the oral cavity. However, the results of these trials have not provided a satisfactory answer to the controversy.…”

Section: Introductionmentioning

confidence: 99%

To Operate or Not to Operate N0 Neck in Early Cancer of the Tongue? A Prospective Study

Vijayakumar

Burrah

Sabitha

et al. 2011

Indian J Surg Oncol

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“…Some books and reference list of each article obtained were checked for further potential studies ( Figure 3). The authors of one of the original articles [169] included in the study were contacted for additional information.…”

Section: Search Strategy and Methods For Identification Of Studymentioning

confidence: 99%

“…Primary tumor control can be achieved by an appropriate surgical operation with or without radiotherapy. However, controversies exist on the management of the neck in clinically node-negative neck (N0) patients although; the available management policies include observation, elective neck dissection, or irradiation [71,99,169]. Even though there is no universal consensus guideline on the management of the neck in squamous cell carcinoma of oral cavity with clinical N0 necks, the predominant opinion is elective neck dissection [117,136].…”

Section: Introductionmentioning

confidence: 99%

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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

et al. 2011

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Elective Neck Dissection vs Observation in Early-Stage Squamous Cell Carcinoma of the Oral Tongue With No Clinically Apparent Lymph Node Metastasis in the Neck

Abu‐Ghanem

Yehuda

Carmel

et al. 2016

JAMA Otolaryngol Head Neck Surg

142

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

Abstract: Observation may be an acceptable alternative to END if strict adherence to a cancer surveillance protocol is followed.

Cited by 217 publications

References 13 publications

To Operate or Not to Operate N0 Neck in Early Cancer of the Tongue? A Prospective Study

To Operate or Not to Operate N0 Neck in Early Cancer of the Tongue? A Prospective Study

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

Elective Neck Dissection vs Observation in Early-Stage Squamous Cell Carcinoma of the Oral Tongue With No Clinically Apparent Lymph Node Metastasis in the Neck

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