Occult lymph node metastasis in small oral tongue cancers.
The need to treat the neck in patients with a small primary cancer in the tongue remains controversial. Twenty-eight patients with stage I or II oral tongue squamous carcinomas were retrospectively reviewed. They had not received previous treatment. The tongue primary was excised via the transoral route and the neck was observed closely during follow-up. Thirteen patients developed ipsilateral nodal metastases during follow-up, three of whom also had simultaneous recurrence at the primary site. An additional patient had recurrence at the primary site alone. The incidence of occult neck metastasis was 42% (10 of 24). No tumor-related death occurred in the group without nodal metastasis. The salvage rate after appearance of nodal metastasis was 30%. In oral tongue cancers, elective neck treatment should be considered regardless of a small primary and negative neck examination because of the high incidence of occult nodal metastasis and the poor outcome after salvage treatment.
Ho
C M
CM
Department of Surgery, Queen Mary Hospital, University of Hong Kong.
Lam
K H
KH
Wei
W I
WI
Lau
S K
SK
Lam
L K
LK
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate; D014062:Tongue Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery