Objective: To compare the effectiveness of selective neck dissection (SND) with radical or modified radical neck dissection (RND) for the management of tongue squamous cell carcinoma with clinically negative nodes (cN0).
Methods: There were 33 patients who were treated with SND (including 14 supraomohyoid neck dissection and 19 level I -IV neck dissection ) between January 1998 and December 2002. According to T classifications, treatment modality and pathological status of lymph node (pN), the control group of 33 patients were randomly selected from the cN0 tongue squamous cell carcinoma patients who were treated with RND between January of 1980 and December of 1997. Kaplan-Meier was used to calculate the rate of regional recurrence and 5-year survival rate.
Results: The neck recurrent for RND population was 9.1% (3 patients), which was not statistically different from the neck recurrent in the SND population 12.1% (4 patients). Also, the 5-year survival rates were no statistic difference between SND and RND groups (82.9%, 28 patients vs 78.8%, 26 patients). The rate of recurrent outside the dissection area for level I -IV neck dissection population was 0, which was statistically different from the rate of recurrent outside the dissection area in the supraomohyoid neck dissection population (14.3%, 2 patients).
Conclusions: Comparing to the radical or modified neck dissection, the SND offered the same oncologic compromise for patients with cN0 tongue squamous cell carcinoma. I -IV neck dissection was recommended.