Ben,
I started in on a long email but decided to pm you (look under my stuff that will be blinking). It is mostly about my case, and lymph nodes.

The thing is, your community hospital could follow the NCCN guidelines for your cancer, they could follow the protocol of a larger hospital, and you could be more certain they do if you got a second opinion. Google National Comprehensive Cancer Network, or just NCCN. You have to join, or create an account, or something, but then you can get into and look at protocol yourself. Maybe you've done that.

Oral cavity cancer: you cannot rely on radiation to be your primary weapon, have to use surgery. I don't know if that applies to nodes of oral tongue patients, but I did have my treatment at one of those NCCN insitutions, MD Anderson, so I would guess that is the way to go. I've looked at the guidelines but it has been a while back. Yes, I think you should have had more lymph nodes removed. The PA to my ENT at MDA put it this way, roughly: we get patients all the time that don't have it all done right the first time, I guess partly because their doctors want to go easy on them, then they get a recurrence. His point was better get it done right the first time.

Yes, you have metastases to those three lymph nodes if the path report says so.

Best,
Anne