title: Selective neck dissection is effective in N1/N2 nodal stage oral cavity squamous cell carcinoma.
abstract: OBJECTIVE
  Although the efficacy of selective neck dissection (SND) in the management of a node-negative neck is established, its utility in the management of node-positive disease remains controversial. The objective of this study was to evaluate the oncologic safety of SND in the management of N1/N2 oral cavity squamous cell carcinoma.
  
  
  METHODS
  From a prospectively collected electronic database of patients with oral cavity cancer, a retrospective analysis was conducted of patients with nonrecurrent, clinical, and/or pathologic N1/N2 oral cavity squamous cell carcinoma who underwent SND of levels I to III/IV. The patients were stratified into 2 groups: clinical N0 but pathologic N1/N2 (cN0-pN1/N2) and clinical N1/N2 (cN1/N2). The primary outcome variable of the study was the ipsilateral regional recurrence rate. Categorical data were analyzed by the 2-sided Fisher exact test, and 3-year Kaplan-Meier ipsilateral regional control rate, regional recurrence-free survival, disease-free survival, and overall survival were estimated.
  
  
  RESULTS
  Forty-nine patients constituted the study sample, with 37 patients in the cN1/N2 group and 12 patients in the cN0-pN1/N2 group. During the follow-up period of 3 years, 2 patients (∼4%) developed ipsilateral neck recurrence, and these patients were in the cN1/N2 group. The 3-year Kaplan-Meier ipsilateral regional control rate was 95%.
  
  
  CONCLUSIONS
  SND may produce a satisfactory ipsilateral regional control rate in patients with early-stage node-positive oral squamous cell carcinoma. A prospective, randomized clinical trial comparing SND with modified radical neck dissection may be required for a categorical conclusion of these findings.
authors.affiliation: Head and Neck Surgical Oncology, Ivy Hospital, Mohali, Punjab, India.
authors.forename: Azhar Jan
authors.initials: AJ
authors.lastname: Battoo
authors.forename: Naveen
authors.initials: N
authors.lastname: Hedne
authors.forename: Sheikh Zahoor
authors.initials: SZ
authors.lastname: Ahmad
authors.forename: Krishnakumar
authors.initials: K
authors.lastname: Thankappan
authors.forename: Subramania
authors.initials: S
authors.lastname: Iyer
authors.forename: Moni Abraham
authors.initials: MA
authors.lastname: Kuriakose
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D037981:Neck Dissection / Q000379:methods*; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012449:Safety; D016896:Treatment Outcome