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This study aimed to identify clinicopathological predictors of recurrence and survival to improve patient-specific strategies for neck management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This retrospective study included 74 patients with histologically confirmed TSCC. All patients underwent standardized staging including [\u00b9\u2078F] FDG PET\/CT. Predictor variables included clinical tumor size (cT), suspicious cervical nodes (cN) and number of metastatic lymph nodes (pN). Outcome parameters comprised overall survival (OS), recurrence-free survival (RFS), local recurrence, regional recurrence and contralateral nodal recurrence and disease-specific mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 1- and 5-year OS rates were 97% and 83%, respectively, and RFS rates were 80% and 61%. Perineural invasion (PNI) was significantly associated with inferior OS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03) and RFS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021). The number of metastatic lymph nodes independently predicted mortality (OR\u2009=\u20091.5; 95% CI: 1.08\u20132.16;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018). Each additional suspicious node on [\n                      <jats:sup>18<\/jats:sup>\n                      F] FDG PET\/CT increased the odds of advanced nodal stage (pN2b OR\u2009=\u20092.49;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008; pN3b OR\u2009=\u20092.65;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Contralateral lymphatic drainage occurred in 21.6% and metastases in 5.4% of patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Preoperative [\n                      <jats:sup>18<\/jats:sup>\n                      F] FDG PET\/CT nodal burden, tumor size and contralateral drainage patterns are potential predictors for patient-specific tailoring of the extent and laterality of neck dissection in TSCC.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical relevance<\/jats:title>\n                    <jats:p>Quantifying nodal burden and integrating biological factors such as perineural invasion and sex-related differences may refine individualized surgical strategies and improve prognostic accuracy beyond conventional TNM staging.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00784-026-06754-6","type":"journal-article","created":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T05:42:33Z","timestamp":1772862153000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic factors and cervical lymph node management in tongue squamous cell carcinoma: a retrospective cohort study"],"prefix":"10.1007","volume":"30","author":[{"given":"Mario","family":"Scheurer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Daut","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Schulze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Grunert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisa","family":"Schramm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Kasper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Wilde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Schramm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majeed","family":"Rana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Ebeling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Sakkas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,7]]},"reference":[{"issue":"3","key":"6754_CR1","doi-asserted-by":"publisher","first-page":"e24327","DOI":"10.1097\/MD.0000000000024327","volume":"100","author":"KY Choi","year":"2021","unstructured":"Choi KY, Park SC, Kim JH, Lee DJ (2021) The occult nodal metastasis rate of early tongue cancer (T1-T2): a protocol for a systematic review and meta-analysis. 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