Prophylactic neck dissection in squamous cell carcinoma of oral tongue: A prospective randomized study

Abstract

This paper presents the first report of an ongoing prospective randomised clinical trial in early T₁T₂N₀ carcinoma of the oral tongue. The problems of regular follow‐up in an indigent population from the vast rural expanse of India has been successfully overcome in this trial by close personal follow‐up. The trial addresses itself specifically to prophylactic vs. therapeutic surgical management of the neck in T₁T₂N₀ patients with cancer of the oral tongue. Overall disease, free survival (median follow‐up 22 months) is higher (64% vs. 47%) in the group receiving prophylactic neck dissection. Disease‐free survival for those with positive nodes at prophylactic neck dissection was twice that of those who underwent a subsequent therapeutic neck dissection (57% vs. 28%). Contralateral neck node metastasis has been identified as a significant factor in neck failures in those patients undergoing simultaneous prophylactic neck dissection.