title: Elective neck dissection versus observation in the management of early tongue carcinoma with clinically node-negative neck: a retrospective study of 229 cases.
abstract: BACKGROUND
  The aim of the study is to evaluate the results of elective neck dissection (END) versus conservative management (observation) in the treatment of stages I and II squamous cell carcinoma of tongue.
  
  
  METHODS
  This is a retrospective study including 229 patients with surgical treatment between June 1993 and May 2010.
  
  
  RESULTS
  There were 15 (9.6%) patients in the END group and 14 (19.2%) patients in the observation group who developed nodal recurrence alone without associated local recurrence or distant metastasis. Node-related mortality rate was 5.1% (8/156) for END and 12.3% (9/73) for observation. Further analysis for subgroups of stage T1 showed that the patients from END group had a better 5-year disease-specific survival (DSS) than those from the observation group in spite of no statistical difference (87.2% vs. 76.0%, Log-rank p = 0.282). END compared with observation for patients with stage T2 had a better 5-year DSS (74.2% vs. 41.2%, Log-rank p = 0.008).
  
  
  CONCLUSIONS
  Elective neck dissection significantly reduces mortality due to lymph nodal metastasis and also increases the 5-year DSS, most marked in patients with stage T2 OSCC. This retrospective study suggests that END should be a preferred treatment strategy for tongue carcinoma in stage T2.
authors: Department of Oral and Maxillofacial Surgery, School of Stomatology, Peking University, No. 22 Zhong-Guan-Cun South Road, Hai-Dian District, Beijing 100081, China.
authors: Zhien
authors: Z
authors: Feng
authors: Department of Oral and Maxillofacial Surgery, School of Stomatology, Peking University, No. 22 Zhong-Guan-Cun South Road, Hai-Dian District, Beijing 100081, China.
authors: Jian Nan
authors: JN
authors: Li
authors: Department of Oral and Maxillofacial Surgery, School of Stomatology, Peking University, No. 22 Zhong-Guan-Cun South Road, Hai-Dian District, Beijing 100081, China.
authors: Chuan Zhen
authors: CZ
authors: Li
authors: Department of Oral and Maxillofacial Surgery, School of Stomatology, Peking University, No. 22 Zhong-Guan-Cun South Road, Hai-Dian District, Beijing 100081, China. Electronic address: guodazuo@sina.com.
authors: Chuan Bin
authors: CB
authors: Guo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D015331:Cohort Studies; D018572:Disease-Free Survival; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate; D014062:Tongue Neoplasms / Q000601:surgery*; D016896:Treatment Outcome; D057832:Watchful Waiting; D055815:Young Adult
keywords: Elective neck dissection; Observation; Prognosis; Squamous cell carcinoma; Tongue