T1 and T2 squamous cell carcinoma of the oral tongue: Prognostic factors and the role of elective lymph node dissection

Background. The management of micrometastatic disease from squamous cell ca rcinoma (SCC) of the oral tongue remains controversial, This study describe s prognostic factors in the disease and reviews the role of elective neck d issection (END). Methods. A retrospective analysis of all patients undergoing definitive sur gical treatment of T1 and T2 SCC of the oral tongue between 1956 and 1994 a t the University of Alabama at Birmingham was performed. Results. Patient, disease, and treatment variables were compiled for 169 pa tients. Multivariate analysis showed age (p =.02), sex (p =.02), disease di fferentiation (p =.0003), and palpable lymphadenopathy (p =.02) to be signi ficant prognostic variables. Fifteen patients underwent END and 6 were show n to have micrometastatic disease (40.0%). There were no neck recurrences i n these patients, but END was not shown to improve survival. Conclusions. The presence of pearly differentiated disease gave the worst p rognosis in this population of patients with T1 and T2 SCC of the oral tong ue. A high incidence of nodal micrometastatic disease and the absence of re current disease after END suggest that END is appropriate therapy for these patients. (C) 1999 John Wiley & Sons, Inc.