Whenever someone asks about "what next" following clean margins in surgical removal of oral cancer I always wince, and tell them to be careful. Notice my own oral cancer was extremely small, 1 mm in depth, classified as superficially invasive initially. Even the repeat path report at MD Anderson, where I ended up, called it cancer in situ at the least, so obviously a somewhat shallow lesion that somehow got out of control. I have my own view of what happened, not necessary to go into here.

You don't mention scans, and if that has not been done that will surely be done before anything invasive, even FNB (fine needle biopsy). In my case the FNB showed abnormal cells, completely replacing anything that was normally in a lymph node. When I had neck dissection surgery at MDA, the surgeon removed two lymph nodes (the bad one and another) and sent them to pathology before they took 28 more. Luckily only the one was metastatic, but as you will note I got the works because my cancer, moderately differentiated as is your wife's, was aggressive and had penetrated the lymph node capsule, called "ECE". Actually I found that ECE particularly when confined to one lymph node is not as frightening as what it first seemed. Bad enough, but studies show when doctors are aggressive in treating it, patients can do well.

Hopefully your wife won't have my issues, but it is best to find out now what, if anything, is in the lymph nodes. If there is nothing there, you and the doctors can closely watch it.

Truly wishing you all the best,
Anne