title: Clinical outcome of surgical treatment of T1-2 N0 squamous cell carcinoma of oral tongue with observation for the neck: Analysis of 176 cases.
abstract: OBJECTIVE
  To analyze various demographic, clinical, and histopathologic factors in T1-2 N0 squamous cell carcinoma (SCC) of the oral tongue to define a high-risk group for regional recurrence that will benefit from elective neck dissection.
  
  
  METHODS
  Retrospective outcome analysis of a patient cohort without palpable or ultrasound (USG) detectable nodal metastases undergoing per oral wide glossectomy for T1-2 N0 SCC of oral tongue. Patients were followed up using palpation and serial USG neck and fine-needle aspiration cytology.
  
  
  RESULTS
  Of the 176 patients, 69 (39%) showed recurrence during follow-up. Fifty-eight cases developed regional neck node metastases, i.e., overall regional node recurrence rate of 33%. Fifty-three (91%) with regional neck node metastases were salvaged successfully with further treatment. In 110 cases with tumor thickness more than 5 mm, 39% cases developed regional neck node metastases. This association was significant withP= 0.0402. Among 44 cases with perineural invasion, 54% developed regional neck node metastases. Similarly in 39 cases with lymphovascular invasion, 61% developed regional neck node metastases. Association of both of these parameters with the development of regional neck node metastases was significant.
  
  
  CONCLUSIONS
  We recommend prophylactic selective neck dissection in early stage SCC of oral tongue, especially with depth of invasion more than 5 mm, perineural and lymphovascular invasion.
authors.affiliation: Department of Surgical Oncology, Prince Aly Khan Hospital, Mazagaon, Mumbai, Maharashtra, India.
authors.forename: Arsheed Hussain
authors.initials: AH
authors.lastname: Hakeem
authors.affiliation: Department of Surgical Oncology, Prince Aly Khan Hospital, Mazagaon, Mumbai, Maharashtra, India.
authors.forename: Sultan Ahmed
authors.initials: SA
authors.lastname: Pradhan
authors.affiliation: Department of Surgical Oncology, Prince Aly Khan Hospital, Mazagaon, Mumbai, Maharashtra, India.
authors.forename: Rajan
authors.initials: R
authors.lastname: Kannan
authors.affiliation: Department of Surgical Oncology, Prince Aly Khan Hospital, Mazagaon, Mumbai, Maharashtra, India.
authors.forename: Jagadish
authors.initials: J
authors.lastname: Tubachi
keywords: Elective neck dissection; nodal metastases; squamous cell carcinoma; tongue