Comparison Between PET-CT-Guided Neck Dissection and Elective Neck Dissection in cT1-2N0 Tongue Squamous Cell...

Area of Science:

• Oncology
• Surgical Oncology
• Diagnostic Imaging

Background:

• Neck management for early-stage (cT1-2N0) tongue squamous cell carcinoma (SCC) lacks definitive guidelines.
• The role of elective neck dissection (END) versus selective approaches is debated.
• Positron Emission Tomography-Computed Tomography (PET-CT) offers potential for improved staging and treatment guidance.

Purpose of the Study:

• To compare the efficacy of PET-CT guided neck management versus elective neck dissection (END) in cT1-2N0 tongue SCC.
• To evaluate the impact of PET-CT guided strategy on regional control (RC) and disease-specific survival (DSS).

Main Methods:

• Retrospective analysis of surgically treated cT1-2N0 tongue SCC patients.
• Group A: Neck dissection decisions based on preoperative PET-CT results.
• Group B: Patients received standard END without preoperative PET-CT.
• Kaplan-Meier analysis for 5-year RC and DSS.

Main Results:

• Group A (n=66) and Group B (n=169) showed no significant difference in 5-year regional control rates (86% vs 87%, p=0.731).
• Disease-specific survival rates at 5 years were also comparable (93% vs 90%, p=0.583).
• Only 16 patients in Group A required neck dissection based on positive PET-CT findings.

Conclusions:

• PET-CT imaging can safely guide the avoidance of neck dissection in clinically node-negative (cN0) early-stage tongue SCC.
• A negative PET-CT scan in cT1-2N0 tongue SCC suggests that elective neck dissection may not be necessary, preserving oncologic outcomes.