Occult lymph node metastasis in small oral tongue cancers

Abstract

The need to treat the neck in patients with a small primary cancer in the tongue remains controversial. Twenty‐eight patients with stage I or II oral tongue squamous carcinomas were retrospectively reviewed. They had not received previous treatment. The tongue primary was excised via the transoral route and the neck was observed closely during follow‐up. Thirteen patients developed ipsilateral nodal metastases during follow‐up, three of whom also had simultaneous recurrence at the primary site. An additional patient had recurrence at the primary site alone. The incidence of occult neck metastasis was 42% (10 of 24). No tumor‐related death occurred in the group without nodal metastasis. The salvage rate after appearance of nodal metastasis was 30%. In oral tongue cancers, elective neck treatment should be considered regardless of a small primary and negative neck examination because of the high incidence of occult nodal metastasis and the poor outcome after salvage treatment. © 1992 John Wiley & Sons, Inc.