Contralateral neck failure in oral tongue cancer: Outcomes from two centers using predefined treatment criteria

Head Neck. 2021 Mar 17. doi: 10.1002/hed.26671. Online ahead of print.


Background: The objective was to determine the incidence of, and factors associated with contralateral neck failure (CNF) in oral tongue squamous cell carcinoma (OTSCC).

Methods: Consecutive patients with OTSCC between 2007 and 2016 were included. The predefined policy of the contralateral neck included neck dissection (ND) where the primary tumor extended/crossed midline or the contralateral neck was involved; and elective nodal irradiation (ENI) where the primary tumor was ≤1 cm from midline/2 cm from tip.

Results: This study included 258 patients. ND was ipsilateral 169 (66%) and bilateral 33 (13%). Fifty-five patients (21%) received ENI to the undissected contralateral neck. CNF occurred in 19 patients (7%) and was similar by treatment received. Utilizing this approach, we observed higher rates of CNF with increasing N classification, perineural invasion, extracapsular extension, and depth of invasion ≥6 mm.

Conclusions: Using our institutional policy of treatment to the contralateral neck, a low rate of CNF (≤10%) was observed.

Keywords: contralateral lymph node metastasis; head and neck cancer; oral tongue squamous cell carcinoma; radiation therapy; surgery.