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Updated: Sep 9, 2025
04:45
Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way
Published on: May 10, 2021
3.9K
Neck Dissection Reduces Risk of Recurrence in Early-Stage Oral Tongue Cancer
Jaclyn Lee1, Tan Ding2, Mae Wimbiscus3
1Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Head & Neck
|August 28, 2025
Summary
Elective neck dissection in early oral tongue cancer surgery significantly reduces recurrence risk, especially for tumors with a depth of invasion of 2mm or more. This finding aids in optimizing treatment strategies for oral tongue squamous cell carcinoma.
Area of Science:
- Oncology
- Surgical Oncology
- Head and Neck Cancer Research
Background:
- Early-stage oral tongue squamous cell carcinoma (OTSCC) management with surgery alone has understudied patterns of failure.
- Understanding recurrence predictors is crucial for refining treatment protocols.
Purpose of the Study:
- To identify predictors of recurrence in early-stage OTSCC treated with surgery.
- To evaluate the impact of elective neck dissection (END) on recurrence rates.
Main Methods:
- Retrospective cohort study of 201 pT1-T2N0 OTSCC patients undergoing partial glossectomy.
- Analysis included patients with or without END, excluding adjuvant therapies.
- Multivariate Cox proportional hazards model used to determine recurrence predictors.
Main Results:
- Recurrence observed in 31% of patients, with local and regional failures being most common.
- Positive margins, perineural invasion, and depth of invasion (DOI) were significant predictors of recurrence.
- Upfront END demonstrated a significant reduction in recurrence risk (HR 0.31), particularly for DOI ≥ 2mm.
Conclusions:
- Upfront elective neck dissection is associated with decreased recurrence in early-stage OTSCC patients treated with surgery alone.
- The benefit of END in reducing recurrence begins at a depth of invasion of 2mm.
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