Prospective trial to evaluate staged neck dissection or elective neck radiotherapy in patients with CT-staged T1-2 N0 squamous cell carcinoma of the oral tongue.
BACKGROUND
A prospective study was undertaken to evaluate a policy of selective, single-modality elective neck treatment in T1-2, node-negative oral tongue squamous cell carcinoma.


METHODS
Where the primary tumor showed 1 of the 4 key pathological criteria (greater than 7 mm of muscle invasion, less than 5 mm of resection margin, perineural or lymphovascular invasion), radiotherapy was delivered to the primary site and the at-risk undissected neck. Otherwise patients underwent ipsilateral neck dissection within 4 weeks of initial resection. Prospective quality of life assessments were performed.


RESULTS
The study was closed after accrual of 25 patients, because the high locoregional recurrence rate met early stopping criteria. With a median follow-up of 3.4 years, the locoregional recurrence rate was 23%. The 4-year overall and disease-free survival rates were 71% and 64%, respectively.


CONCLUSIONS
The poor disease-free survival reflects the need for better prognostic markers and more aggressive treatment in these patients.
Brennan
Sinead
S
Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia. sinead.brennan@slh.ie
Corry
June
J
Kleid
Stephen
S
Porceddu
Sandro
S
Yuen
Kally
K
Rischin
Danny
D
Peters
Lester J
LJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging / Q000379:methods; D011446:Prospective Studies; D011788:Quality of Life; D014057:Tomography, X-Ray Computed