Elective neck dissection versus watchful waiting in the management of early tongue cancers with node negative neck: our experience of 68 cases

Authors

  • Anchal Gupta Department of Otorhinolaryngology, SMGS Government Medical College, Jammu, Jammu and Kashmir UT, India
  • Rupali Sharma Department of Otorhinolaryngology, SMGS Government Medical College, Jammu, Jammu and Kashmir UT, India
  • Gopika Kalsotra Department of Otorhinolaryngology, SMGS Government Medical College, Jammu, Jammu and Kashmir UT, India
  • Arun Manhas Department of Otorhinolaryngology, SMGS Government Medical College, Jammu, Jammu and Kashmir UT, India
  • Dev Raj Department of Community Medicine Government Medical College, Jammu, Jammu and Kashmir UT, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20214488

Keywords:

Cancer, Occult, Tongue

Abstract

Background: Prognosis for tongue squamous cell carcinoma depends upon lymph node metastasis and the treatment plan depends upon the management of cervical lymph node metastasis.

Methods: A prospective analysis of early squamous cell carcinoma oral tongue was done February 2017 to February 2020 in previously untreated and biopsy proven patients with T1-2N0 cancer of tongue and patients with clinically negative nodes on the basis of palpation, ultrasound and computerized tomography (CT) and previously untreated and biopsy proven patients with T1-2N0 cancer of oral cavity. After proper work up, patients were divided into two groups. Group 1 (n=35) patients that underwent a surgical excision of primary tumor with 15mm safe margin and selective neck dissection (level I, II, III), group 2 (n=33) patients that underwent surgical excision of primary tumor with 15 mm safe margin and neck observation. All patients with tumor thickness ≥4 mm were included in this group. 

Results: The study included 51 (75%) males and 17(25%) female patients. In this study, recurrence was significantly related to tumor thickness (p<0.05) i.e., >4 mm tumor thickness showed significantly higher local recurrence and nodal recurrences. Also, a significantly higher relationship was seen between nodal recurrence and postoperative close surgical margins (p<0.05).

Conclusions: Elective neck dissection becomes necessary in patients with T2N0 tumors and tumor thickness of >4 mm as frequency of occult metastasis and recurrence is more in these patients.

Author Biographies

Anchal Gupta, Department of Otorhinolaryngology, SMGS Government Medical College, Jammu, Jammu and Kashmir UT, India

MS ENT, Lecturer, Department of Otorhinolaryngology, SMGS Hospital, Government Medical College, Jammu, Jammu and Kashmir UT, India.

Rupali Sharma, Department of Otorhinolaryngology, SMGS Government Medical College, Jammu, Jammu and Kashmir UT, India

MBBS, Post Graduate Student, Department of Otorhinolaryngology, SMGS Hospital, Government Medical College, Jammu, Jammu and Kashmir UT, India.

Gopika Kalsotra, Department of Otorhinolaryngology, SMGS Government Medical College, Jammu, Jammu and Kashmir UT, India

Assistant Professor, Department of Otorhinolaryngology, SMGS Hospital, Government Medical College, Jammu, Jammu and Kashmir UT, India.

Arun Manhas, Department of Otorhinolaryngology, SMGS Government Medical College, Jammu, Jammu and Kashmir UT, India

MBBS, Post Graduate Student, Department of Otorhinolaryngology, SMGS Hospital, Government Medical College, Jammu, Jammu and Kashmir UT, India.

Dev Raj, Department of Community Medicine Government Medical College, Jammu, Jammu and Kashmir UT, India

Senior Lecturer Statistics, Postgraduate Department of Community Medicine Government Medical College, Jammu, Jammu and Kashmir UT, India

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Published

2021-11-25

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Original Research Articles