Abstract Introduction
Oral cavity carcinoma is an aggressive
tumor, with the
tongue being one of the most common subsites of involvement.
Surgery is a
gold standardmethod of dealing with advanced-stage
tumors. However, for early-stage
carcinomas of the
tongue, the management remains controversial. Several studies have indicated that early-stage
cancers have a high chance of occult cervical node
metastasis, which, if left untreated, can greatly
affect the
prognosis. Certain
parameters can help identify
patients with occult cervical node
metastases, and can avoid unnecessary
neck dissection in node negative
patients.
Tumor thickness is one such objective parameter. Objective To estimate the frequency of cervical
lymph node metastasis in
patients with early-stage, node-negative (N0)
squamous cell carcinoma of the
tongue.
Methods In-
patient hospital data was reviewed from January 2013 until March 2014, and 78
patients who underwent primary resection of the
tumor and
neck dissection for
biopsy-proven, early stage
squamous cell carcinoma of the
tongue were included. Data such as
tumor thickness,
tumor differentiation and presence of occult nodal
metastasis in the surgical specimen were gathered from the histopathology
reports. The frequency of subclinical cervical
lymph node metastasis in
patients with early-stage
squamous cell carcinoma of the
tongue was estimated. Results A total of 69% of the
patients with
tumor thicknesses > 5 mm had
tumor metastases in the
neck nodes, while 100% of the
patients with
tumor thicknesses < 5 mm had no
neck nodal
metastasis. Conclusion A
tumor thickness > 5 mm is significantly associated with subclinical
metastasis, and prophylactic
neck dissection is warranted in such cases.