title: Indications and extent of elective neck dissection in patients with early stage oral and oropharyngeal carcinoma: nationwide survey in The Netherlands.
abstract: BACKGROUND
  Different strategies are available for the management of patients with early (i.e. tumour stage one or two) oral or oropharyngeal carcinoma and a clinically negative neck.
  
  
  METHODS
  In 2006, a questionnaire was sent to the eight head and neck cancer centres of the Dutch Head and Neck Oncology Cooperative Group. This questionnaire covered: the factors influencing the decision to perform an elective neck dissection; the neck staging procedure; and the types of neck dissection undertaken.
  
  
  RESULTS
  All eight questionnaires were returned completed. Respondents indicated that the site (n = 6), size (n = 7) and thickness (n = 6) of the primary tumour were important in decisions regarding elective neck dissection. Ultrasound-guided fine needle aspiration cytology was the most frequently used diagnostic technique (n = 7). Depending on the site and stage of the primary tumour presented, in the different cases 3-7 of the centres would perform an elective neck dissection. Selective neck dissections (i.e. levels I to III/IV) were more frequently performed than modified radical neck dissections.
  
  
  CONCLUSIONS
  There was no uniformity regarding management of the clinically negative neck in patients with early stage oral and oropharyngeal carcinoma, within The Netherlands.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands. r.bree@vumc.nl
authors.forename: Remco
authors.initials: R
authors.lastname: de Bree
authors.forename: I
authors.initials: I
authors.lastname: van der Waal
authors.forename: P
authors.initials: P
authors.lastname: Doornaert
authors.forename: J A
authors.initials: JA
authors.lastname: Werner
authors.forename: J A
authors.initials: JA
authors.lastname: Castelijns
authors.forename: C R
authors.initials: CR
authors.lastname: Leemans
mesh_terms: D044963:Biopsy, Fine-Needle / Q000379:methods / Q000592:standards; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D003657:Decision Making; D017558:Elective Surgical Procedures / Q000379:methods* / Q000592:standards; D006801:Humans; D009062:Mouth Neoplasms / Q000601:surgery*; D009333:Neck / Q000601:surgery; D037981:Neck Dissection / Q000379:methods* / Q000592:standards; D009361:Neoplasm Invasiveness; D009426:Netherlands; D009959:Oropharyngeal Neoplasms / Q000601:surgery*; D010347:Patient Care Planning; D011795:Surveys and Questionnaires; D016896:Treatment Outcome