Management of the neck in early-stage (pT1-T2, cN0) oral cavity tumors: Oral tongue and floor of mouth

The treatment approach to the neck is guided by the location of the primary tumor, tumor size and DOI, as well as available clinical expertise in the procedure of choice.
Refer to UpToDate content on management of early-stage oral cavity cancer. As examples:

• We prefer surgical neck dissection rather than RT, as this approach improved survival in randomized trials and provides pathologic staging. RT is a reasonable alternative for patients who are ineligible for or decline surgery.
• The choice between SLNB or elective neck dissection may depend on the skill, training, and preference of the surgeon.
• The accuracy of SLNB in floor of mouth tumors may be lower than that of oral tongue tumors. Due to the close proximity of the radiotracer injection site to the lymph nodes at risk, radioactivity from the injection site may mask sentinel node activity.