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Is neck ultrasound necessary for early stage oral tongue carcinoma with clinically N0 neck?

EWH To^,1, WM Tsang^*,2, J Cheng¹, E Lai¹, P Pang¹, AT Ahuja³ and M Ying⁴

¹ Division of Head and Neck, Plastic & Reconstructive Surgery, Prince of Wales Hospital, Shatin, Hong Kong; ² Oral Maxillofacial Surgery and Dental Unit, Prince of Wales Hospital, Shatin, Hong Kong; ³ Department of Diagnostic Radiology & Organ Imaging, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; ⁴ Department of Optometry and Radiography, The Hong Kong Polytechnic University, Hong Kong

*Correspondence to: Dr Tsang Wai-Ming, Oral Maxillofacial Surgery and Dental Unit, Prince of Wales Hospital, Shatin, Hong Kong; Email: tsang.wai-ming{at}graduate.hku.hk

Received 17 October 2002; revised 24 February 2003; accepted 23 April 2003

Objectives: To define the necessity of neck ultrasound for investigation of T1 and T2 oral tongue carcinoma with N0 neck.

Methods: The medical records of all patients with early stage (T1–2 N0) oral tongue cancer treated surgically between January 1985 and December 2000 were reviewed. Patients with 30 neck dissections were identified for analysis. The result of neck ultrasound examination was correlated with the histological examination.

Results: The sensitivity, specificity and overall accuracy of ultrasound examination were found to be 47%, 93% and 70%, respectively. The implication of ultrasound examination with respect to elective neck treatment was discussed in the management of the N0 neck.

Conclusions: It is concluded that ultrasound alone is inadequate for making decisions regarding neck management of patients with T1 and T2 N0 carcinoma of the tongue and cannot replace a policy of elective neck dissection.

Keywords: ultrasonography; tongue; carcinoma