title: [Regularity and therapeutic strategy of cervical lymph node metastasis in squamous cell carcinoma of the tongue].
abstract: OBJECTIVE
  At present, whether neck dissection should be employed in squamous cell carcinoma (SCC) of the tongue with clinically node negative neck(cN0) is still controversial. This study was designed to explore the regularity of cervical lymph node metastasis in SCC of the mobile part of the tongue, and to discuss the theories and principles of employment of selective neck dissection in cN0 cases.
  
  
  METHODS
  A retrospective research was performed on clinical data of 214 cases of SCC of the tongue treated with surgery from 1991 to 1997. Distribution of cervical lymph node metastasis of cN0 pN(+)= (pathologically node positive) and cN(+) (clinically node positive) pN(+)= cases were analyzed; the survival rates of different groups were compared; the factors that impact the survival of SCC of the tongue were screened out by Cox regression analysis.
  
  
  RESULTS
  Cervical lymph node metastases were found in 69 cases. The metastatic rate was 32.2%. Metastases occurred in level I, II, III, IV, V of the ipsilateral neck were 22.3%, 33.5%, 22.3%, 4.6%, 1.0%, in level I,II,III, IV,V of the contralateral neck were 6.6%, 3.6%, 3.0%, 2.0%, 0.5%, respectively. The 5-year survival rates of the pN(+)= group and the pN0 group were 47% and 83%, respectively(P< 0.001). T stage and N stage were independent factors that impact the long-term outcome of SCC of the tongue.
  
  
  CONCLUSIONS
  Level I,II,III of the ipsilateral neck tend to be involved when cervical lymph node metastases occur. Selective neck dissection can be used to treat the cervical metastasis in cN0 cases, as well as to evaluate the cervical lymph node status in order to determine whether comprehensive neck dissection should be employed.
authors.affiliation: Department of Head and Neck Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, P.R. China. tjkzl@gzsums.edu.cn
authors.forename: Zhu-Ming
authors.initials: ZM
authors.lastname: Guo
authors.forename: Quan
authors.initials: Q
authors.lastname: Zhang
authors.forename: Zong-Yuan
authors.initials: ZY
authors.lastname: Zeng
authors.forename: Fu-Jin
authors.initials: FJ
authors.lastname: Chen
authors.forename: Mao-Wen
authors.initials: MW
authors.lastname: Wei
authors.forename: Han-Wei
authors.initials: HW
authors.lastname: Peng
authors.forename: Guang-Pu
authors.initials: GP
authors.lastname: Xu
authors.forename: Wen-Kuan
authors.initials: WK
authors.lastname: Chen
authors.forename: Zhang-Feng
authors.initials: ZF
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D005260:Female; D006801:Humans; D008198:Lymph Nodes; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D037981:Neck Dissection; D015996:Survival Rate; D014062:Tongue Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery