CC-BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2018; 22(02): 136-140
DOI: 10.1055/s-0037-1603626
Original Research
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Frequency of Cervical Nodal Metastasis in Early-Stage Squamous Cell Carcinoma of the Tongue

Sadaf Qadeer Ahmed
1  Department of Otorhinolaryngology, Sir Syed College of Medical Sciences for Girls, Karachi, Pakistan
Montasir Junaid
2  Department of Otorhinolaryngology, Armed Forces Hospitals Southern Region, Khamis Mushayt, Saudi Arabia
Sohail Awan
3  Department of Otorhinolaryngology, Aga Khan University, Karachi, Pakistan
Maliha Kazi
4  Department of Otorhinolaryngology, Manchester Royal Infirmary, Manchester, United Kingdom of Great Britain and Northern Ireland
Hareem Usman Khan
5  Department of Medicine, Shifa College of Medicine, Islamabad, Pakistan
Sohail Halim
6  Department of Pathology, Aga Khan University, Karachi, Pakistan
› Author Affiliations
Further Information

Publication History

07 November 2016

01 April 2017

Publication Date:
06 June 2017 (eFirst)


Introduction Oral cavity carcinoma is an aggressive tumor, with the tongue being one of the most common subsites of involvement. Surgery is a gold standard method of dealing with advanced-stage tumors. However, for early-stage carcinomas of the tongue, the management remains controversial. Several studies have indicated that early-stage cancers have a high chance of occult cervical node metastasis, which, if left untreated, can greatly affect the prognosis. Certain parameters can help identify patients with occult cervical node metastases, and can avoid unnecessary neck dissection in node negative patients. Tumor thickness is one such objective parameter.

Objective To estimate the frequency of cervical lymph node metastasis in patients with early-stage, node-negative (N0) squamous cell carcinoma of the tongue.

Methods In-patient hospital data was reviewed from January 2013 until March 2014, and 78 patients who underwent primary resection of the tumor and neck dissection for biopsy-proven, early stage squamous cell carcinoma of the tongue were included. Data such as tumor thickness, tumor differentiation and presence of occult nodal metastasis in the surgical specimen were gathered from the histopathology reports. The frequency of subclinical cervical lymph node metastasis in patients with early-stage squamous cell carcinoma of the tongue was estimated.

Results A total of 69% of the patients with tumor thicknesses > 5 mm had tumor metastases in the neck nodes, while 100% of the patients with tumor thicknesses < 5 mm had no neck nodal metastasis.

Conclusion A tumor thickness > 5 mm is significantly associated with subclinical metastasis, and prophylactic neck dissection is warranted in such cases.

Supplementary Material