Treatment of cervical lymph nodes in carcinoma of the tongue

Treatment of the regional lymph nodes forms an integral part of the management of any patient with carcinoma of the tongue. It is the most important determinant of survival. Although survival correlates with the size of the primary tumor, it may also be explained by the higher incidence of metastatic nodes in larger lesions. The incidence of contralateral neck nodes is high, and treatment of the contralateral neck, even in smaller carcinomas of the tongue, must be considered. Anterior tongue carcinomas are equally as aggressive as posterior carcinomas of the tongue. An analysis of the cause of failure following treatment of tongue carcinomas emphasizes the fact that too many clinical stages I and II cancers--those with clinically negative neck examination--are in fact pathologic stage III cancers.