Does elective neck dissection in T1/T2 carcinoma of the oral tongue and floor of the mouth influence recurrence and survival rates?
The aim of this study was to evaluate the results of elective neck dissection compared with observation (control group) in selected cases of early carcinoma of the oral tongue and floor of the mouth. It was a retrospective analysis of 222 patients who had the tumour resected (161 also had elective neck dissection). Occult lymph node metastases were detected in 33/161 (21%), and neck recurrences were diagnosed in 10 of the 61 patients in the control group (16%). Occult lymph node metastases reduced the 5-year disease-specific survival from 90% to 65% (p=0.001) and it was 96% among the controls. The 5-year disease-specific survival was 85% in the group treated by neck dissection and 96% in the observation group (p=0.09). Rigorous follow-up of selected low risk patients is associated with high rates of salvage, and overall survival was similar to the observed survival in patients treated by elective neck dissection. Observation is a reasonable option in the treatment of selected patients.
Department of Head and Neck and Otorhinolaryngology Surgery, ACCamargo Cancer Center, São Paulo, Brazil. Electronic address: nataliekelner@yahoo.com.br.
Natalie
N
Kelner
Department of Head and Neck and Otorhinolaryngology Surgery, ACCamargo Cancer Center, São Paulo, Brazil. Electronic address: jgvartanian@uol.com.br.
José Guilherme
JG
Vartanian
Department of Pathology, ACCamargo Cancer Center, São Paulo, Brazil. Electronic address: coipinto@uol.com.br.
Clóvis Antônio Lopes
CA
Pinto
Department of Pathology, ACCamargo Cancer Center, São Paulo, Brazil. Electronic address: claumcc@terra.com.br.
Cláudia Malheiros
CM
Coutinho-Camillo
Department of Head and Neck and Otorhinolaryngology Surgery, ACCamargo Cancer Center, São Paulo, Brazil. Electronic address: lp_kowalski@uol.com.br.
Luiz Paulo
LP
Kowalski
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D018572:Disease-Free Survival; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009060:Mouth Floor / Q000473:pathology / Q000601:surgery*; D009062:Mouth Neoplasms / Q000473:pathology / Q000601:surgery*; D037981:Neck Dissection / Q000379:methods*; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D019651:Plastic Surgery Procedures / Q000379:methods; D016879:Salvage Therapy / Q000379:methods; D015996:Survival Rate; D014062:Tongue Neoplasms / Q000473:pathology / Q000601:surgery*; D057832:Watchful Waiting; D055815:Young Adult
Early stage; Elective neck dissection; Lymph nodes; Oral cancer; Squamous cell carcinoma