TREATMENT OF STAGE-I AND STAGE-II ORAL TONGUE CANCER

We reviewed 156 previously untreated patients with squamous cell carci noma of the oral tongue staged T1 and T2 to determine the incidence of nodal metastasis, and if elective neck dissection affected local/regi onal control or survival. Patients were divided into two nonrandomized groups: group 1, intraoral glossectomy only (102 patients); and group 2, intraoral glossectomy plus neck dissection (54 patients). Analysis revealed no significant differences for tumor location, histologic di fferentiation, status of margins, or clinical appearance; however, per ineural invasion significantly adversely affected survival and local/r egional control. In group 1 patients, 16.5% subsequently developed cer vical metastasis, and 20.4% of patients in group 2 had occult nodal di sease. The survival and local/regional control for group 1 patients su bsequently developing nodes was 33% and 50%, respectively. The surviva l and local/regional control for group 2 patients with occult metastas is was 55% and 91%, respectively. We believe elective neck dissection is indicated for early staged oral tongue cancer.