Elective neck dissection for the management of the N0 neck in early cancer of the oral tongue: need for a randomized controlled trial.
BACKGROUND
The aim of this study is to determine the need for a randomized controlled trial in order to define the role of an elective neck dissection (END) in the treatment of early tongue cancers.


METHODS
We present a large retrospective analysis of patients with T1-2 N0 squamous cell cancers of the oral anterior tongue treated at a single institution. A total of 359 eligible patients with early tongue cancers were divided into 2 groups: END and wait and watch (WW). An analysis for survival outcomes and prognostic factors was conducted.


RESULTS
The estimated 3- and 5-year disease-free survival for the END group was 76% and 74% versus 71% and 68% for the WW group, respectively (p = .53). The 3- and 5-year overall survival (OS) rate for the END group was 69% and 60% versus 62% and 60% for the WW group, respectively (p = .24). Tumor grade and perineural invasion were independent predictors of recurrence.


CONCLUSIONS
END did not impact disease-free or OS. Current literature still remains divided on this issue emphasizing the need for a randomized controlled trial.
D'Cruz
Anil K
AK
Division of Head Neck Surgery, Tata Memorial Hospital, Mumbai, India. adcruz@vsnl.com
Siddachari
Ravichand C
RC
Walvekar
Rohan R
RR
Pantvaidya
Gouri H
GH
Chaukar
Devendra A
DA
Deshpande
Mandar S
MS
Pai
Prathamesh S
PS
Chaturvedi
Pankaj
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D003657:Decision Making; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D016019:Survival Analysis; D014062:Tongue Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*