Hi, Brendan,
I had a similar surgery to yours, and I also had a similar diagnosis, although my lesion was not as big. It did metastasize very early, there are theories why that happened, but none proven. Tongue cancer (David's catagory 3 that we fall into) is very aggressive and tricky. But treated in ways that employ surgery first and radiation where needed, some studies have shown the results/prognosis can be very good. My submandibular gland was also removed. Prior to my surgery I was having some trouble with my submandibular functioning correctly because of where the duct came out and my first tongue surgery. My parotids were spared. I had saliva throughout my treatment, vanished although not totally for a while, and is coming back now. If you have a choice, keep your parotids, they are the best.

My cancer was also moderately well diff. So that means it is more likely to metastasize than well diff. There is a lot of controversy about neck dissection. If you don't have it and then have a metastasis, then you could possibly think, "I wish I had done it." If you do have it and get along great except for the problems associated w/the surgery, then you might think, "I wish I had not done it." But having said that, the same person may say "I'd rather be safe than sorry." Scans are only accurate to a point. I had a CT one week that showed no involved nodes, then 4 weeks later was back with one.

Probably what I would suggest is to visit with your doctor about the neck dissection, and why he or she recommends it. I have seen studies where they look at the odds for Stage 2 oral tongue cancer and what determines whether or not they do the dissection is the depth of the lesion, or aggressiveness/histology of it--we are talking about the differentiation, or whether or not the margins were wide. So that might be a why.

Best to you,
Anne