Prospective randomized study of selective neck dissection versus observation for N0 neck of early tongue carcinoma.
BACKGROUND
There are controversies on the benefits of elective neck dissection (END) for oral tongue carcinoma.


METHODS
This is a prospective randomized study of elective selective I, II, III neck dissection versus observation for N0 neck of stage I to II oral tongue carcinoma. There were 35 patients on the observation arm and 36 patients on the END arm. The main outcome assessment parameters are node-related mortality and disease-specific survival rate.


RESULTS
There were 11 patients in the observed arm and 2 patients in the END arm who developed nodal recurrence alone without associated local or distant recurrence. All 13 patients were salvaged, and no patient died of nodal recurrence. The 5-year disease-specific survival rate was 87% for the observation arm and was 89% for the END arm; the 2% difference was not significant.


CONCLUSIONS
Observation may be an acceptable alternative to END if strict adherence to a cancer surveillance protocol is followed.
Yuen
Anthony Po-Wing
AP
Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong. pwyuen@hkucc.hku.hk
Ho
Chiu Ming
CM
Chow
Tam Lin
TL
Tang
Lap Chiu
LC
Cheung
Wing Yung
WY
Ng
Raymond Wai-Man
RW
Wei
William Ignace
WI
Kong
Chi Kwan
CK
Book
Kwok Shing
KS
Yuen
Wai Cheung
WC
Lam
Alfred King-Yin
AK
Yuen
Nancy Wah-Fun
NW
Trendell-Smith
Nigel Jeremy
NJ
Chan
Yue Wai
YW
Wong
Birgitta Yee-Hang
BY
Li
George Kam-Hop
GK
Ho
Ambrose Chung-Wai
AC
Ho
Wai Kuen
WK
Wong
Sau Yan
SY
Yao
Tzy-Jyun
TJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D037981:Neck Dissection / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D019370:Observation / Q000379:methods*; D018579:Patient Selection; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D016019:Survival Analysis; D014062:Tongue Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D016896:Treatment Outcome