舌体鳞癌颈淋巴结转移的规律和治疗策略

背景与目的:目前,对临床颈淋巴结阴性(cN0)的舌癌病例是否需行颈淋巴清扫术治疗仍存争议。本研究目的在于探讨舌体鳞癌的颈部淋巴结转移规律和分区性颈淋巴结清扫术应用于cN0舌癌病例的理论依据和应用原则。方法:回顾性分析1991年至1997年214例手术治疗的舌体鳞癌患者的临床资料;分析cN0pN+(病理检查淋巴结阳性)病例和cN+pN+病例的颈部转移淋巴结分布规律;比较不同分组的远期疗效;Cox回归分析法筛选影响舌体鳞癌患者预后的因素。结果:pN+病例69例,颈淋巴结转移率32.2%,其中同侧Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ区各占22.3%、33.5%、22.3%、4.6%、1.0%;对侧Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ区各占6.6%、3.6%、3.0%、2.0%、0.5%。pN+组和pN0组5年生存率各为47%、83%(P<0.001);Cox回归分析显示影响舌体鳞癌患者预后的独立因素为T分期、N分期。结论:舌体鳞癌淋巴结转移最常见于同侧颈部Ⅰ、Ⅱ、Ⅲ区;分区性颈淋巴结清扫术对cN0病例既可起治疗的作用,又可用于评价颈部淋巴结转移状况以决定是否行全颈淋巴结清扫术。     

舌体鳞癌颈淋巴结阴性患者的颈部治疗策略

目的探讨舌体鳞癌N0患者颈部淋巴结治疗方法,以减少临床上的失误或过度治疗.方法对1985至2002年间165例舌体鳞癌N0患者进行回顾性研究.对部分T1、T2及T3期患者切除原发灶,进行颈部观察;其余T2期以上患者或无法随访的T1期者采取选择性颈淋巴清扫,全部病例术后随访3年以上.各组间的比较采用χ2检验.结果 120例行选择性颈淋巴清扫术(END),33例术后病理证实淋巴结转移,45例单纯原发灶切除病例中9例出现颈淋巴转移.淋巴结隐匿性总转移率为25.5%,并随临床T分期的增高而增高.观察组总体颈部失控死亡率(20.0%)与END组(5.0%)相比,差异有显著性(P<0.05).T1期观察组和END组的颈部失控死亡率分别为7.7%和4.0%,两组间差异无显著性(P>0.05);而将T2、T3期作为中期病变合并,观察组(70.0%)和END组(0)差异有显著性(P<0.001).结论舌体鳞癌颈部隐匿性淋巴结转移率随临床T分期的增高而增高,对T2期以上N0舌体鳞癌患者应考虑行选择性颈清扫术,以提高其颈部控制率和生存率;对T1N0患者,如能够严密随访,可考虑单纯局部切除原发灶,以提高生存质量.     

T1、T2 No舌活动部鳞癌隐匿性颈淋巴结转移的规律及治疗

目的　探讨T1、T2 舌鳞癌隐匿性颈淋巴结转移的分布特点和治疗方式。方法　回顾性分析中山大学肿瘤医院 133例T1、T2 No舌活动部鳞癌病例 ,根据隐匿性颈淋巴结转移分布探讨早期舌鳞癌的转移规律 ;分析选择性全颈淋巴结清扫术和区域性颈淋巴清扫术的预后。结果　 133例早期舌鳞癌中 32例发生隐匿性颈淋巴结转移 ,转移率是 2 4.1% ;隐匿性颈淋巴结主要分布在levelⅡ( 5 2 .6 % )、其次是levelⅠ( 36 .8% )、再次是levelⅢ ( 7.9% )、以及对侧levelⅠ( 2 .6 % ) ,levelⅣ和Ⅴ无隐匿性转移淋巴结存在。本组选择性全颈清扫组、区域性颈清扫组 (levelⅠ～Ⅲ)和未颈清扫组的 5年生存率分别是 83 .5 %、76 .9%和 71.0 % ,三组两两间无统计学差异 (P >0 .0 5 ) ;T1舌鳞癌中颈淋巴结清扫组与未行颈淋巴结清扫组的生存率分别为 87.6 %和 80 .0 % ,两组间无统计学差异 (P >0 .0 5 ) ;T2 舌鳞癌全颈清扫组、区域性清扫组和未行颈清扫组患者的 5年生存率为 80 .6 %、74.1%和 6 1.1% ,全颈清扫和区域性清扫组间存在着统计学差异 (P <0 .0 5 )。所有患者的 5年生存率是 78.2 %。结论　T1、T2 No舌鳞癌隐匿性颈淋巴结转移主要分布在levelⅠ、Ⅱ和Ⅲ ;T1舌鳞癌颈部以观察为主 ,T2 宜施行levelⅠ、Ⅱ和Ⅲ(上半颈 )选择性颈     

舌体鳞癌隐匿性颈淋巴结转移的外科治疗探讨

背景与目的:对于临床颈淋巴结阴性(cN0)的舌癌颈部的处理一直存在争议,本研究旨在探讨cN0舌体鳞癌颈部的合理治疗方案。方法:回顾性分析187例手术前后未行放、化疗的cN0舌体鳞癌初诊患者的临床资料;分析颈部隐匿性淋巴结转移规律和隐匿性淋巴结转移及预后的影响因素,以及颈部不同处理方式的控制情况。结果:隐匿性淋巴结转移率为23.0%,其最常见的位置在同侧颈Ⅱ区,83.0%的隐匿性淋巴结转移分布在同侧颈Ⅰ、Ⅱ、Ⅲ区;病理分级是影响隐匿性淋巴结转移的独立因素;隐匿性淋巴结转移为影响cN0舌癌患者预后的独立因素;肩胛舌骨肌上清扫术的颈部复发率为6.7%。结论:肩胛舌骨肌上颈清扫术是cN0舌体鳞癌患者有效而安全的治疗措施。     

125例cT1-2NO舌鳞癌治疗后复发的相关因素分析

背景与目的:cT1-2N0舌鳞癌的治疗存在颇多争议,且术后复发率较高,挽救性治疗的成功率低.本研究旨在探讨cT1-2NO舌鳞癌治疗后复发的相关因素,及诸因素对生存率的影响,以指导临床选择更合理的治疗方法.方法:回顾性分析中山大学肿瘤防治中心1992年1月至2000年12月收治的125例cT1-2N0期舌鳞癌患者的临床资料(T1 58例和T2 67例),所有患者的治疗方式以手术为主,17例(13.6%)只行原发灶手术,53例(42.4%)行原发灶手术加选择性颈清扫,55例(44.0%)行综合治疗.x2检验和Cox模型分析性别、病程、生长方式、肿瘤部位、分化程度、TNM分期、隐匿性颈淋巴结转移、浸润深度、颈部处理、治疗方案、手术方式与复发、预后的关系.结果:125例患者有41例复发,总复发率是32.8%.总的5年生存率为62.59%,复发组与未复发组的5年生存率分别为38.74%、74.69%,两组比较有统计学意义(log-rank=19.27,P＜0.001).经统计学分析显示,cT1-2NO舌癌的复发与病程(x2检验,P=0.002)、生长方式(x2检验,P＜0.001)、颈部处理(x2检验,P＜0.001)、隐匿性颈淋巴结转移(x2检验,P=0.040)显著相关.舌癌的预后与浸润深度(Cox回归,P=0.005)和复发部位(Cox回归,P＜0.001)有显著相关性.结论:病程、生长方式、颈部处理和隐匿性淋巴结转移是cT1-2NO舌癌复发的重要因素.浸润深度和复发部位是影响预后的重要因素.     

125例cT1-2N0舌鳞癌治疗后复发的相关因素分析

背景与目的:cT1-2N0舌鳞癌的治疗存在颇多争议,且术后复发率较高,挽救性治疗的成功率低。本研究旨在探讨cT1-2N0舌鳞癌治疗后复发的相关因素,及诸因素对生存率的影响,以指导临床选择更合理的治疗方法。方法:回顾性分析中山大学肿瘤防治中心1992年1月至2000年12月收治的125例cT1-2N0期舌鳞癌患者的临床资料(T158例和T267例),所有患者的治疗方式以手术为主,17例(13.6%)只行原发灶手术,53例(42.4%)行原发灶手术加选择性颈清扫,55例(44.0%)行综合治疗。x2检验和Cox模型分析性别、病程、生长方式、肿瘤部位、分化程度、TNM分期、隐匿性颈淋巴结转移、浸润深度、颈部处理、治疗方案、手术方式与复发、预后的关系。结果:125例患者有41例复发,总复发率是32.8%。总的5年生存率为62.59%,复发组与未复发组的5年生存率分别为38.74%、74.69%,两组比较有统计学意义(log-rank=19.27,P<0.001)。经统计学分析显示,cT1-2N0舌癌的复发与病程((2检验,P=0.002)、生长方式(x2检验,P<0.001)、颈部处理((2检验,P<0.001)、隐匿性颈淋巴结转移(x2检验,P=0.040)显著相关。舌癌的预后与浸润深度(Cox回归,P=0.005)和复发部位(Cox回归,P<0.001)有显著相关性。结论:病程、生长方式、颈部处理和隐匿性淋巴结转移是cT1-2N0舌癌复发的重要因素。浸润深度和复发部位是影响预后的重要因素。     

早期舌鳞状细胞癌的疗效分析

目的 分析不同方法治疗Ⅰ、Ⅱ期舌鳞癌的疗效.方法 回顾性分析103例Ⅰ、Ⅱ期舌鳞癌患者,比较单纯手术、单纯放疗和综合治疗(术前或术后放疗)的疗效及其影响因素.结果Ⅰ、Ⅱ期患者的5年生存率分别为82.4%和80.O%(P=0.361),其中单纯手术组、单纯放疗组和综合治疗组的5年生存率分别为90.3%、68.4%和84.0%(P=0.104),局部复发率分别为2.5%、35.7%和5.7%(P＜0.001).隐匿性淋巴结转移率为23.8%,其中Ⅱ区的转移率(19.0%)最高.局部复发、区域复发是影响患者预后的独立因素,单纯手术即能获得满意的局部控制,而低分化鳞癌易出现区域复发.结论 选用单纯手术治疗早期舌癌,如采用择区性颈淋巴清扫术,清扫范围为Ⅰ～Ⅳ区.     

早期舌鳞癌的隐匿性淋巴结转移与治疗

目的：研究18例I期和Ⅱ期舌鳞癌的颈部隐匿性转移和挽救治疗的效果。方法：18例病以前均未接受过治疗。原发灶经口腔切除,并密切随访观察颈部。结果：手术切缘均呈阴性。11%（2/18）的病人原发灶处有复发,局部控制率是89%（16/18）。50%（9/18）的病人在随访期中发现锁骨上淋巴结转移。在原发灶已控制的情况下,淋巴结转移率是44%（7/16）。总的五年生存率是67%（12/18）。颈部隐匿性转移的病人五年生存率是27%（3/7）。结论：舌癌颈部隐匿性转移率较高,挽救成功率较低。因此,我们建议对早期舌鳞癌应施行选择性颈清扫术或预防性放射治疗,以提高生存率。     

T1、T2No舌活动部鳞癌隐匿性颈淋巴结转移的规律及治疗

目的：探讨T1、T2舌鳞癌隐匿性颈淋巴结转移的分布特点和治疗方式。方法：回顾性分析中山大学肿瘤医院133例T1，T2No舌活动部鳞癌病例，根据隐匿性颈淋巴结转移分布探讨早期舌鳞癌的转移规律；分析选择性全颈淋巴结清扫术和区域性颈淋巴清扫术的预后。结果：133例早期舌鳞癌中32例发生隐匿性颈淋巴结转移，转移率是24．1％，隐匿性颈淋巴结主要分布在leveⅡ（52．6％），其次是LeveII（36．8）％，再次是leveⅢ（7．9％），以及对侧leveII(2.6%),leveIV和V无隐匿性转移淋巴结存在。本组选择性全颈清扫组，区域性颈清扫组（leveII-Ⅲ）和未颈清扫组的5年生存率分别是83．5％，76．9％和71．0％，三组两两间无统计学差异（P＞0．05），T1舌鳞癌中颈淋巴结清扫组与未行颈淋巴结清扫组的生存率分别为87．6％和80．0％，两组间无统计学差异（P＞0．05），T2舌鳞癌全颈清扫组，区域性清扫组和未行颈清扫组患的5年生存率为80．6％，74．1％和61．1％，全颈清扫和区域性清扫组间存在着统计学差异（P＜0．05），所有患的5年生存率是78．2％。结论：T1、T2No舌鳞癌隐匿性颈淋巴结转移主要分布在leveI,II和Ⅲ，T1舌鳞癌颈部以观察为主，T2宜施行leveI,II和Ⅲ（上半颈）选择性颈淋巴清扫术。     

早期舌鳞癌复发原因及预后因素的分析

背景与目的：早期舌癌的治疗效果理想,但复发是影响早期舌癌治疗效果的重要因素。本研究回顾性分析227例早期舌癌的临床资料,探讨早期舌癌复发的主要原因及影响预后的因素。方法：收集中山大学肿瘤防治中心1992—2003年首治的227例早期舌鳞癌患者的临床资料,Kaplan—Meier法对各影响因素进行生存率分析并计算生存率,log-rank法比较各因素不同水平生存分布的差异。Cox同归模型进行多因素分析,影响复发不同因素间比较用卡方检验。结果：高分化鳞癌组复发率为19.3％,中高低分化鳞癌组复发率为39．2％,二者的差异具有统计学意义（P=0．004）,综合治疗组复发率为15％,单纯手术组复发率为28％．二者的差异具有统计学意义（P=0．014）。复发组及非复发组3年及5年生存率分别为40．7％、87.3％及25．9％、80．3％,二者的差异具有统计学意义（P=0.000）。行颈清扫组及未行颈清扫组3年及5年生存率分别为为76．4％、75．0％及68％、61．2％．二者的差异具有统计学意义（P=0．023）;≥45岁组及〈45岁组3年及5年生存率分别为75．6％、78％及59．5％、66．1％,二者的差异具有统计学意义（p=0．021）。结论：病理分级及是否进行综合治疗是影响早期舌癌复发的原因,患者的年龄、是否行颈清扫、是否复发是影响早期舌癌预后的因素,年龄及是否复发是影响预后的独立因素。     

Impact of elective neck dissection on regional recurrence and survival in cN0 staged oral maxillary squamous cell carcinoma

To evaluate the impact of elective neck dissection (END) on regional recurrence and survival in cN0 staged patients with maxillary squamous cell carcinoma (SCC). Eighty-six patients with maxillary SCC and clinically staged N0 cervical lymph-nodes were evaluated in this single center retrospective study. Seventy-four of 86 patients were included in this analysis, of which 36 patients were treated with END, 38 without END. Following END, pathohistologically verified regional lymph-nodes in the initially cN0 neck were found in three (8%) patients. In both the +END and non-END group regional recurrences occurred exclusively in patients with T4 primaries. The overall regional recurrence rate was 17% in the +END and 18% in the non-END group, respectively. The 5-year overall survival rate for all tumor stages combined (T1-T4) was 86% in the +END group and 82% in the -END group. Within the patients groups with T4 tumors, 5-year overall survival was 81% for the +END group and 56% for the -END group. Over all tumor stages combined (T1-T4), END did not significantly improve overall survival rates and did not prevent the rate of regional recurrence in cN0 staged patients with maxillary alveolar, gingival and palatal SCC. However, in the subgroup of patients with locally advanced T4 tumors, their seemed to be a clear tendency towards improvement of overall survival in the END group. END can therefore be recommended for these patients.     

Occult cervical metastasis of squamous cell carcinoma of tongue among CN0 patients and its treatment

Objective： To explore the treatment of clinically negative neck （CN0） patients with squamous cell carcinoma of the tongue. Methods： 165 CN0 patients with squamous cell carcinoma of the tongue from 1985 to 2002 were investigated retrospectively. Parts of the patients staged at T1, T2 and T3 underwent resection of primary lesion followed by neck observation, and other patients staged above T2 or at T1 but without follow-up were treated with elective neck dissection （END）. All patients were followed up for more than 3 y or until their death. Results： Lymphatic metastasis was identified histologically after operation in 33 of 120 patients treated with END, and 9 of 45 patients treated with resection of primary lesion alone. The overall rate of occult lymphatic metastasis was 25.45%, which increased with the elevating of clinical T stage. The overall rate of neck uncontrolled death was 20.00% for observation group and 5.00% for END group, and significant difference was found between them （P〈0.05）. For T~ patients in the two groups, the rate of neck uncontrolled death was 7.71% and 4.00% respectively, and no significance was found between them （P〉0.05）. When stage T2 and T3 were considered as middle stage together, significant difference （P〈0.05） could be obtained between observation （70.00%） and END group （0%）. Conclusion： The occult metastasis rate of squamous cell carcinoma of tongue increases with the elevating of clinical stage, and elective neck dissection could be considered for NO patients staged over T2 to improve neck control and survival rate; and regional resection alone of primary lesion could be considered for T1N0 patients to improve quality of life if closely followed up is conducted.     

Elective Neck Dissection for Management of Early-stage Oral Tongue Cancer

Background: The occult neck metastasis rate is very high with tongue cancers. The aim of this study was to assessthe current role of elective neck dissection (END) in management of early-stage oral tongue cancer with a focus onlymph node metastasis. In addition, effects of END on regional or systemic disease recurrence and survival wereinvestigated. Methods: This retrospective study included patients with stage I and II tongue cancer recruited fromour National Cancer Institute (NCI) over a time period of six years (2007-2013). The collected data were analyzed fordisease free survival (DFS) and recurrence rate. Results: A total of 144 patients presented to our NCI with oral tonguecancer but only 88 were staged clinically and radiologically as early stage (stage I, stage II). Some 53% were smokers.Most lesions were dealt with by surgery, either by wide local excision (22%) or hemiglossectomy (78%). Treatment ofneck lesions was either by neck dissection (85.2%) or “wait and see” (14.8%). The rates for local and nodal recurrencewere 7.9% and 20.4%, respectively. Analysis of associations between DFS and different factors revealed significancefor adoption of adjuvant therapy and the dissected lymph node status. Conclusion: Controversy still exists regardingneck management.     

Poor prognosis in patients with stage I and II oral tongue squamous cell carcinoma

BACKGROUND: The objective of this study was to compare survival in patients with squamous cell carcinoma (SCC) of the oral tongue with that in patients with SCC in other oral cavity subsites. METHODS: Patients with stage I and II (T1-T2N0M0) SCC of the oral cavity diagnosed between 1988 and 2004 were queried by using the Surveillance, Epidemiology, and End Results (SEER) database. The log-rank test was used to compare the overall survival (OS) and cause-specific survival (CSS) of patients who had oral tongue SCC with those of patients who had SCC of other oral cavity subsites. A Cox proportional hazards multivariate analysis was performed to evaluate the influence of covariates on the risk of CSS and OS. RESULTS: Between 1988 and 2004, 6791 patients with stage I and II SCC of the oral cavity were identified. Among them, 40% had oral tongue SCC, and 60% had SCC of other oral cavity subsites. The median patient age was 64 years. The 5-year OS and CSS rates were 60.9% and 83.5%, respectively, for patients with oral tongue SCC versus 64.7% and 94.1%, respectively, for patients with SCC of other oral cavity subsites (OS: hazard ratio, 1.24; P< .0001; CSS: hazard ratio, 3.04; P< .0001). On multivariate analysis, OS and CSS were influenced significantly by T classification, age, sex, and oral tongue subsite. The CSS for patients who had stage I and II oral tongue SCC also was unfavorable compared with the CSS for stage-matched patients who had SCC of other head and neck sites. CONCLUSIONS: Oral tongue SCC was associated with poor survival compared with other oral cavity and head and neck sites. These data suggested a potential benefit for multimodality therapy in this cohort of patients.     

Stage I-II squamous cell carcinoma of the oral cavity treated by iridium-192: is elective neck dissection indicated?

This is a retrospective analysis of 233 evaluable patients with stage I-II squamous cell carcinoma of the oral cavity treated by definitive branchytherapy. Minimum follow-up is 3 years. Treatment of neck was chosen by a multidisciplinary team, according to age, medical status and availability for regular follow-up. One hundred and ten patients (47%) underwent elective neck dissection (END); 28 (25%) had positive nodes and received neck irradiation post-operatively. One hundred and twenty three patients (53%) were regularly followed up only, with therapeutic neck dissection (TND) reserved for cases of node relapses. In the END group, there were 19 neck relapses (17%): 12/60 (20%) in patients with mobile tongue carcinoma and 7/50 (14%) in patients with floor of the mouth carcinoma. Salvage treatment was successful in 9/19 (47%) cases. In the TND group, there were 21 neck relapses (17%): 16/82 (20%) in patients with mobile tongue carcinoma and 5/41 (10%) in patients with floor of the mouth carcinoma. Salvage treatment was successful in 13/21 (62%) cases. Ten-year survival is 37% for the END group and 31% for the TND group. Tumour stage and infiltration into underlying tissues increased the probability of neck relapse and death. Furthermore, a multivariate analysis showed that patients treated in the TND group had a higher probability of death than patients treated in the END group (p less than 0.04).     

Tumour thickness predicts cervical nodal metastases and survival in early oral tongue cancer

Squamous cell carcinoma (SCC) of the oral tongue is characterized by a high propensity for cervical nodal metastasis, which affects the probability of regional control and survival. Until now, elective treatment of the clinically negative neck in early lesions (T(1-2)) of the oral tongue cancer remains controversial. This study attempted to identify predictive factor(s) for cervical nodal metastasis and treatment outcomes in patients with early stage SCC of the oral tongue treated primarily by surgery. Fifty patients with previously untreated Stage I/II primary tongue carcinomas with available archival specimens treated at the Royal Marsden Hospital between 1981 and 1998 were reviewed. Clinico-pathological features including age, gender, alcohol and tobacco consumption, tumour location, histological grade, tumour-stromal border, growth pattern, tumour thickness, and clinical stage were evaluated and the correlations with cervical metastases and outcome analysis were determined. The overall occult nodal metastatic rate was 40% (20/50). Tumour thickness exceeding 5 mm was statistically significantly correlated with cervical metastases (P = 0.003; relative risk = 2.429). No statistical correlation was observed between other clinico-pathological parameters and nodal metastasis. With a median follow-up of 98 months, 5-year actuarial overall, disease-specific (DSS), and relapse-free survival were 65.71, 67.77, and 68.18%, respectively. Univariate analysis for DSS showed poorer outcomes for patients with age > 60 years (P = 0.0423) and tumour thickness > 5 mm (P = 0.0067). The effect of tumour thickness was maintained (P = 0.005) on multivariate analysis. The present study indicates that the thickness of primary tumour has a strong predictive value for occult cervical metastasis and poor outcomes in patients with Stage I/II oral tongue SCC. Thus, elective neck treatment (surgery or irradiation) is indicated for tumours exceeding 5 mm thickness.     

Neck observation versus elective neck dissection in management of clinical T1/2NO oral squamous cell carcinoma: a retrospective study of 232 patients

Objective:The management of early-stage (cT1/2N0) oral squamous cell carcinoma (OSCC) remains a controversial issue.The aim of this study was to compare the clinical outcomes of neck observation (OBS) and elective neck dissection (END) in treating patients with cT1/2N0OSCC.Methods:A total of 232 patients with cT1/2N0OSCC were included in this retrospective study.Of these patients,181 were treated with END and 51 with OBS.The survival curves of 5-year overall survival (OS),diseasespecific survival (DSS),and recurrence-free survival (RFS) rates were plotted using the Kaplan-Meier method for each group,and compared using the Log-rank test.Results:There was no significant difference in 5-year OS and DSS rates between END and OBS groups (OS:89.0％ vs.88.2％,P=0.906;DSS:92.3％ vs.92.2％,P=0.998).However,the END group had a higher 5-year RFS rate than the OBS group (90.1％ vs.76.5％,P=0.009).Patients with occult metastases in OBS group (7/51) had similar 5-year OS rate (57.1％ vs.64.1％,P=0.839) and DSS rate (71.4％ vs.74.4％,P=0.982) to those in END group (39/181).In the regional recurrence patients,the 5-year O S rate (57.1％ vs.11.1％,P=0.011) and D SS rate (71.4％ vs.22.2％,P=0.022) in OBS group (7/51) were higher than those in END group (9/181).Conclusions:The results indicated that OBS policy could obtain the same 5-year OS and DSS as END.Under close follow-up,OBS policy may be an available treatment option for patients with clinical T1/2N0OSCC.     

Neck treatment of patients with early stage oral tongue cancer: comparison between observation, supraomohyoid dissection, and extended dissection

BACKGROUND: The role of elective and therapeutic selective neck dissection in patients with early stage cancer of the oral tongue remains controversial. The purpose was to investigate the role of neck treatment in the management of this condition. METHODS: A total of 380 patients with cT1-2N0 oral tongue cancer were retrospectively reviewed. Patients were staged by means of computed tomography (CT) or magnetic resonance imaging (MRI) scans. A total of 324 patients received elective neck dissection (END), whereas 56 participants received observation (OBS). In all, 287 patients received supraomohyoid neck dissection (SOND), whereas 37 patients received modified radical neck dissection (MRND). Overall survival (OS) and neck control rates (NCR) were investigated according to the treatment modality. RESULTS: In the END group the occult metastasis (OM) rates in cervical lymph nodes were 5.2% for cT1 lesions and 14.6% for cT2 lesion (P = .005). The 5-year OS (P = .029) and NCR rates (P = .001) were significantly better in the END group compared with the OBS group. Patients who received MRND had a better 5-year NCR compared with SOND, albeit not significantly (91.4% vs 85.3%, P = .415). Multivariate analysis showed that END and stage were independent predictors of both NCR and OS. CONCLUSIONS: END should be performed routinely in patients with early-stage oral tongue cancer, even in the presence of negative neck by CT scans and MRI.