Thirty-nine previously untreated patients with squamous cell carcinoma of the oral tongue treated with curative intent in our hospital from 1993 through 1998 are reviewed. Of these patients, those in the early stage (stages I and II) constituted 64%. The over all 5-year survival rate of all the patients was 60%. The 5-year survival rate of the patients with early stage cancers was unsatisfactory (stage I: 73%; II: 56%). This was thought to be related to the absence of elective neck dissection and the administration of chemotherapy in the patients with early stage cancer. We concluded that elective neck dissection for levels I, II and III is the first choice of treatment strategy for patients with stage II cancer. Our data indicate that chemotherapy in patients with early stage cancer was not beneficial and might have increased the risk of late lymph node metastasis in the clinically NO patients without neck dissection. There were 9 patients younger than 40 years of age and their survival rate at 5 years was 80%, which was better than that of the older patients. The treatment strategy for patients younger than 40 years of age was similar to that of older patients.