Neck Dissection Reduces Risk of Recurrence in Early-Stage Oral Tongue Cancer.

Abstract

Patterns of failure in early-stage oral tongue squamous cell carcinoma (OTSCC) managed with surgery alone remain understudied. Retrospective cohort study from 2000 to 2022 at a single tertiary care center evaluated pT1-T2N0 OTSCC patients who underwent partial glossectomy with or without elective neck dissection (END), without any adjuvant therapy. Predictors of recurrence were analyzed via multivariate Cox proportional hazards model. The study included 201 OTSCC patients (131 pT1 and 70 pT2). Eighty patients (40%) underwent glossectomy alone; 121 (60%) underwent glossectomy with END. At a median follow-up of 56 months (IQR 23-82), 63 patients (31%) developed recurrence (21.4% local; 15.9% regional; 1% distant). Positive margins (HR 5.45 [1.9-15.4]), perineural invasion (HR 4.15 [1.8-9.9]), and increasing depth of invasion (DOI) (HR 1.32 [1.1-1.6]) were independently associated with recurrence. Upfront END reduced the risk of recurrence (HR 0.31 [95% CI: 0.15-0.6]), with benefit starting at tumor DOI 2 mm and greater. Upfront END decreases recurrence for pT1-T2N0 OTSCC treated with surgery alone starting at a DOI of 2 mm.