Management of the neck in early oral cancers: Is the verdict out?

Vishal U. S. Rao, Prashant H Patil, BV Rajaram

Journal of Cancer Research and Therapeutics 2016 12(3):1114-1116

The management of patients with the clinically negative neck (N0) in early oral cancers awaits a clear mandate despite growing evidence favoring elective neck dissection. Having a general policy of operating all N0 neck may indeed increase the number of unnecessary neck dissection in the true pathological N0 necks, a more commonly encountered scenario. This controversy needs to be looked beyond statistical evidence to address a larger question to "does the neck truly harbor disease," thus, refining the early age old debate. This article highlights the feasibility of wait and watch policy, while elaborating a stringent algorithm to judiciously select patients in whom the neck may be safely observed.

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