Neck dissection versus a watch and wait strategy in T1N0 tongue cancers

Purpose: The aim of this study was to evaluate the impact of neck dissection on T1N0M0 tongue cancers. Numerous histological features were analyzed to assess the impact of each one on overall survival. Materials and methods: The study included 53 patients with squamous cell carcinoma of the tongue who were treated with tumorectomy and selective neck dissection or neck observation. The patients were divided into two groups: patients who underwent tumorectomy and neck dissection (n=31) and patients treated with tumorectomy and neck observation (n=22). Results: The rate of occult metastasis was 16,1% in the group of patients who underwent neck dissection. No statistically significant difference was found between overall survival and the type of neck treatment (p>0,05). Node involvement and recurrence were two important prognostic factors in clinical T1N0M0 tongue cancers (p<0,05). Conclusion: Considering the high rate of occult metastases in our series (16,1%), we recommend performing neck dissection in cT1N0M0 tongue cancers with a tumor thickness >0,4 cm. Even though the type of neck treatment failed to show a significant relationship with overall survival, neck dissection might offer important prognostic information.