Objective This retrospective study is to analyze the outcomes of cN0 stage tongue squamous cell carcinoma and to discuss a reasonable neck management for these cases. Methods Totally 132 cases of cN0 stage tongue squamous cell carcinomas were included. Seventy-one cases were performed neck dissection（group ND）, 61 cases were under wait-and-see（group WS）. The clinical, pathological and follow up data of two groups were analyzed. Results The cumulative three-year-survival between group ND and group WS were 87.3% and 83.4% respectively. In group ND, the survival of T1 and T2 cases were 89.3% and 83.3% respectively, while 89.6% and 58.3% in WS. For T2b cases which the size was larger than 3.0 cm, the survival of group WS was greatly lower than that of group ND. Both in ND and WS groups. The pathologically poor differentiation cases got poor survival than middle and well cases. Conclusion The wait-and-see policy is recommanded for T1 stage cN0 tongue squamous cell carcinoma. For T2 cases that the tumor size is smaller than 3.0 cm, the wait-and-see is also reasonable, while the neck dissection should be considered in cases of poor differentiation. For large T2 cases, the selective neck dissection should be performed.
