• Natalie Kelner, José Guilherme Vartanian, Clóvis Antônio Lopes Pinto, Cláudia Malheiros Coutinho-Camillo, and Luiz Paulo Kowalski.
• Department of Head and Neck and Otorhinolaryngology Surgery, ACCamargo Cancer Center, São Paulo, Brazil. Electronic address: nataliekelner@yahoo.com.br.
• Br J Oral Maxillofac Surg. 2014 Sep 1;52(7):590-7.

AbstractThe aim of this study was to evaluate the results of elective neck dissection compared with observation (control group) in selected cases of early carcinoma of the oral tongue and floor of the mouth. It was a retrospective analysis of 222 patients who had the tumour resected (161 also had elective neck dissection). Occult lymph node metastases were detected in 33/161 (21%), and neck recurrences were diagnosed in 10 of the 61 patients in the control group (16%). Occult lymph node metastases reduced the 5-year disease-specific survival from 90% to 65% (p=0.001) and it was 96% among the controls. The 5-year disease-specific survival was 85% in the group treated by neck dissection and 96% in the observation group (p=0.09). Rigorous follow-up of selected low risk patients is associated with high rates of salvage, and overall survival was similar to the observed survival in patients treated by elective neck dissection. Observation is a reasonable option in the treatment of selected patients.Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

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