Incidence and control of occult neck node metastases from squamous cell carcinoma of the anterior two-thirds of the tongue.

Cervical lymph node metastases developed in 45% of patients with T1N0 squamous cell carcinomas of the oral tongue in spite of local control of the primary lesions in 79%. The control rate for the neck of those who converted from a negative to a positive neck (N0-N+) was 33%. Neck node metastases developed in 49% of patients with T2N0 tumors. The control rate of the primary tumor was 32%, and the control rate of the neck of those whose neck nodes converted (N0-N+) was 16%. Neck node metastases developed in 42% of patients with T3N0 tumors. The control rate of the primary tumors was 33%, and the control rate of the neck of those who converted (N0-N+) was 7%. The development of neck node metastases in patients after treatment of the primary tongue carcinoma is of grave prognostic significance. The use of elective treatment to the neck at initial treatment can prevent metastases in the neck from developing if the primary tumor is under control.