Occult lymph node metastasis in small oral tongue cancers

Head Neck. Sep-Oct 1992;14(5):359-63. doi: 10.1002/hed.2880140504.


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.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / secondary*
  • Carcinoma, Squamous Cell / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Lymphatic Metastasis / pathology
  • Male
  • Middle Aged
  • Neck / surgery
  • Neck Dissection
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Staging
  • Retrospective Studies
  • Survival Rate
  • Tongue Neoplasms / mortality
  • Tongue Neoplasms / pathology*
  • Tongue Neoplasms / surgery