Locoregional recurrence is the most common cause of failure in the tre
atment of carcinoma in the oral cavity. The extent of the disease can
be evaluated by inspection, endoscopy, palpation, computed tomography
(CT), magnetic resonance imaging (MRI), and ultrasound (US). The treat
ment consists of surgery, radiation, and their combination. The purpos
e of this study was to evaluate the effect of imaging and active treat
ment of the neck in patients with oral cancer. Altogether 31 consecuti
ve patients with 32 squamous cell carcinomas in the oral cavity were i
ncluded. Of the tumors, 5 were T1, 18 were T2, 5 were T3 and 4 were T4
. According to CT and US findings, 19 of the patients had a normal lym
ph node status, whereas 12 patients had enlarged or rim-like enhanced
lymph nodes in the neck. Preoperative radiotherapy to the primary site
and the neck was given to all except 3 patients. Surgery was carried
out in all except 4 patients. A neck dissection was performed in N-pos
itive cases (n = 9) and electively in patients with a high risk of met
astases (n = 10). The median follow-up time was 31 months, with the mi
nimum of 11 months, or until death. Seventeen (55%) of the patients ex
perienced a recurrence. In only 1 patient the recurrence appeared init
ially in the neck, whereas all others had a local recurrence. Later, a
distant metatasis was found in 3 patients. The meticulous imaging and
active treatment of the neck were successful since only one patient's
disease recurred primarily in the neck. The high number of recurrenci
es at the primary site show the need for intensified therapy.