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ORIGINAL ARTICLE RETROSPECTIVE STUDY
Year : 2016  |  Volume : 6  |  Issue : 2  |  Page : 235-240

Clinical outcome of surgical treatment of T1-2 N0 squamous cell carcinoma of oral tongue with observation for the neck: Analysis of 176 cases


Department of Surgical Oncology, Prince Aly Khan Hospital, Mazagaon, Mumbai, Maharashtra, India

Correspondence Address:
Arsheed Hussain Hakeem
Prince Aly Khan Hospital, Nesbit Road, Mazagaon, Mumbai - 400 010, Maharashtra
India
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DOI: 10.4103/2231-0746.200331

PMID: 28299264

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Objective: To analyze various demographic, clinical, and histopathologic factors in T1-2 N0 squamous cell carcinoma (SCC) of the oral tongue to define a high-risk group for regional recurrence that will benefit from elective neck dissection. Materials and Methods: Retrospective outcome analysis of a patient cohort without palpable or ultrasound (USG) detectable nodal metastases undergoing per oral wide glossectomy for T1-2 N0 SCC of oral tongue. Patients were followed up using palpation and serial USG neck and fine-needle aspiration cytology. Results: Of the 176 patients, 69 (39%) showed recurrence during follow-up. Fifty-eight cases developed regional neck node metastases, i.e., overall regional node recurrence rate of 33%. Fifty-three (91%) with regional neck node metastases were salvaged successfully with further treatment. In 110 cases with tumor thickness more than 5 mm, 39% cases developed regional neck node metastases. This association was significant with P= 0.0402. Among 44 cases with perineural invasion, 54% developed regional neck node metastases. Similarly in 39 cases with lymphovascular invasion, 61% developed regional neck node metastases. Association of both of these parameters with the development of regional neck node metastases was significant. Conclusion: We recommend prophylactic selective neck dissection in early stage SCC of oral tongue, especially with depth of invasion more than 5 mm, perineural and lymphovascular invasion.


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