Skip to main content

Advertisement

Log in

Management of the node negative early carcinoma tongue

  • Main Article
  • Published:
Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Objective

To determine the role of thickness of the primary lesion in early Squamous Cell Carcinoma (SCC) of the oral tongue for decision-making regarding the management of possible occult cervical node metastases.

Setting

Tertiary referral centre

Patients

Patients who were treated by the authors for early (T1, T2) primary lesions in the oral tongue in two malignancy treatment centres of the Armed Forces Medical Services were included in this prospective study. Where the primary lesion was less than 04 mm in depth, the neck was not addressed electively. Those who developed nodal disease in the neck on follow up were subjected to comprehensive neck dissection. In those patients where the tumour thickness was more than 04 mm, the neck was addressed with at least a supra-omohyoid neck dissection. Postoperative radiotherapy was given as per standard indications. The patients were followed up as per standard protocol.

Results

Disease free survival rate achieved was 86% and this compares well with survival rates achieved by other workers.

Conclusion

Treatment of neck nodes in early (T1,T2) SCC of the oral tongue can be expectant in cases where tumour thickness is less than 04 mm, but where it is more than 04 mm elective treatment of the neck is recommended.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Werning JW, Heard D, Pagano C, Khuder S (2003) Elective management of the clinically negative neck by otolaryngologists in patients with oral tongue cancer. Arch Otolaryngol Head Neck Surg 129(1):83–88

    Article  PubMed  Google Scholar 

  2. Pillsbury HC, Clark M (1997) A rationale for therapy of the N0 neck. Laryngoscope 107:1294–315

    Article  PubMed  Google Scholar 

  3. Kligerman J et al (1994) Supraomohyoid neck dissection in the treatment of T1/T2 squamous cell carcinoma of oral cavity. Am J Surg 168:391–394

    Article  PubMed  CAS  Google Scholar 

  4. Ho CM, Lam KH, Wei WI, Lau SK, Lam LK (1992) Occult lymph node metastasis in small oral tongue cancers. Head Neck 14(5):359–363

    Article  PubMed  CAS  Google Scholar 

  5. Vermund H, Brennhovd I, Kaalhus O, Poppe E (1984) Incidence and control of occult neck node metastases from squamous cell carcinoma of the anterior two-thirds of the tongue. Int J Radiat Oncol Biol Phys 10(11):2025–2036

    PubMed  CAS  Google Scholar 

  6. Hicks WL Jr, North JH Jr, Loree TR, Maamoun S, Mullins A, Orner JB, Bakamjian VY, Shedd DP (1998) Surgery as a single modality therapy for squamous cell carcinoma of the oral tongue. Am J Otolaryngol 19(1):24–28

    Article  PubMed  Google Scholar 

  7. Sparano A, Weinstein G, Chaian A, Yodul M (2004) Multivariate predictors of occult neck metastasis in early oral tongue cancer. Otolaryngol Head Neck Surg 131(4): 472–476

    Article  PubMed  Google Scholar 

  8. Fakih AR, Rao RS, Borges AM, Patel AR (1989) Elective versus therapeutic neck dissection in early carcinoma of the oral tongue. Am J Surg 168:309–313

    Article  Google Scholar 

  9. Hayashi T, Ito J, Taira S, Katsura K (2001) The relationship of primary tumor thickness in carcinoma of the tongue to subsequent lymph node metastasis. Dentomaxillofac Radiol 30(5):242–245

    Article  PubMed  CAS  Google Scholar 

  10. Fukano H, Matsuura H, Hasegawa Y, Nakamura S (1997) Depth of invasion as a predictive factor for cervical lymph node metastasis in tongue carcinoma. Head Neck 19(3): 205–210

    Article  PubMed  CAS  Google Scholar 

  11. Byers RM, Weber RS, Andrews T, McGill D, Kare R, Wolf P (1997) Frequency and therapeutic implications of “skip metastases” in the neck from squamous carcinoma of the oral tongue. Head Neck 19(1):14–19. Comment in: Head Neck. 1997 Aug;19(5):445–446

    Article  PubMed  CAS  Google Scholar 

  12. De Zinis LO, Bolzoni A, Piazza C, Nicolai P (2006) Prevalence and localization of nodal metastases in squamous cell carcinoma of the oral cavity: role and extension of neck dissection. Eur Arch Otorhinolaryngol 263(12):1131–1135

    Article  PubMed  Google Scholar 

  13. Nithya C, Pandey M, Naik B, Ahamed IM (2003) Patterns of cervical metastasis from carcinoma of the oral tongue. World J Surg Oncol 1(1):10

    Article  PubMed  Google Scholar 

  14. Kaya S, Yilmaz T, Gursel B, Sarac S, Sennaroglu L (2001) The value of elective neck dissection in treatment of cancer of the tongue. Am J Otolaryngol 22(1): 59–64

    Article  PubMed  CAS  Google Scholar 

  15. Ross GL, Soutar DS, MacDonald DG, Shoaib T, Camilleri IG, Robertson A (2004) Improved Staging of Cervical Metastases in Clinically Node-Negative Patients with Head and Neck Squamous Cell Carcinoma. Ann Surg Oncol 11: 213–218

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ajith Nilakantan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nilakantan, A., Venkatesh, M.D., Raghavan, D. et al. Management of the node negative early carcinoma tongue. Indian J Otolaryngol Head Neck S 59, 229–232 (2007). https://doi.org/10.1007/s12070-007-0067-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12070-007-0067-5

Keywords

Navigation