Chris,

I was diagnosed with stage I T1N0M0 tongue SCC at age 41 and I insisted on a modified neck dissection in addition to a wide resection of the tongue for two reasons: 1. there is a 20% chance of occult spread to the lymph nodes that won't show up on any scans; 2. this disease spreads through the lymph nodes and if they aren't present and I have a local recurrence, it will be more difficult for it to metastasize. The modified neck dissection is a relatively low risk surgery but I had to do a lot of talking to persuade my surgeon at the University of Pennsylvania to do it. Personally I have a lot more peace knowing that my lymph nodes were clear and now they are gone.

Barb