Ipsilateral neck nodal status as predictor of contralateral nodal metastasis in carcinoma of tongue crossing the midline.

BACKGROUND In squamous cell carcinoma of the tongue, when lesions reach or cross the midline, there is a higher risk of contralateral nodal metastasis. Identifying factors that are associated with higher risk of nodal metastasis may help in optimizing the treatment. METHODS A retrospective analysis was conducted of all patients with squamous cell carcinoma of the tongue who had undergone bilateral neck dissection at Tata Memorial Hospital between January 2007 and June 2010 for a lesion crossing or reaching the midline. RESULTS Contralateral nodal metastases were present in 71 of 243 patients (29%) who underwent bilateral neck dissection. Of these 71 patients, 69 patients (97%) had ipsilateral nodal metastasis. CONCLUSION In carcinoma of the tongue, where lesions reach or cross the midline, the chance of contralateral nodal metastases without ipsilateral nodal metastasis is extremely rare. Frozen section of ipsilateral neck dissection can be a pointer for addressing the contralateral neck.