Lingual lymph nodes in tongue cancers: a systematic review and meta-analysis

Lingual lymph nodes (LLN) are aberrant nodes located in the floor of mouth. Neither are metastases to these nodes routinely investigated nor are they included in the guidelines for management of tongue cancers. This article systematically collates published literature along with a meta-analysis to address clinically relevant questions pertaining to the lingual nodes. A systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. Databases were searched to identify all articles on LLN in English until December 2024. A total of 24 articles were included. Proportional analysis showed an overall incidence of 8.98% (LLN metastasis). Pooled sensitivity of cross-sectional imaging to detect these nodes was 34%. Patients presenting with advanced tumour stage and/or nodal positivity have a higher risk of LLN metastasis. The analysis also showed a higher chance of recurrencein patients with metastatic LLN resulting in poorer outcomes in these tongue cancers.