Introduction. Treatment to the neck of patients with oral tongue cancer (OTC) without palpable nodes (cN0) is controversial. Elective neck dissection (END) could lead to over-treating more than 50% and follow-up indicates high regional recurrence. Decision to perform the surgery depends on the risk of hidden node metastases (NM).
Objective. The objective of this study was to assess the prevalence of hidden NM in cN0-OTC patients undergoing END.
Material and methods. Patients (n=22) with cN0-OTC were treated with partial glosectomy and END.
Results. Of these, 16 were free of node metastases (negative predictive value = 73%) while the other 6 (27%) showed at least one NM. Risk was greater, although statistically not significant, in T3 than in T1-2. Overall survival was better in patients without NM having END (95% versus 38%).
Conclusions. cN0-OTC is associated with 27% of NM, which justifies END. It is necessary to select carefully the candidates for END so as to preclude over-treatment in 73% of patients. Perhaps lymph mapping and sentinel node biopsy will help the better identification of hidden NM.
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