title: Management of the neck in early oral cancers: Is the verdict out?
abstract: 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.
authors.affiliation: Department of Surgical Oncology, HCG Cancer Center, Head and Neck Services, Bengaluru, Karnataka, India.
authors.forename: Vishal U S
authors.initials: VU
authors.lastname: Rao
authors.affiliation: Department of ENT-Head Neck Surgery, Jawaharlal Nehru Medical College, KLE University, Belgaum, Karnataka, India.
authors.forename: Prashant H
authors.initials: PH
authors.lastname: Patil
authors.affiliation: Department of Surgical Oncology, St. John's Medical College, Bengaluru, Karnataka, India.
authors.forename: B V
authors.initials: BV
authors.lastname: Rajaram
mesh_terms: D000465:Algorithms; D019468:Disease Management; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D009333:Neck / Q000473:pathology*; D037981:Neck Dissection; D009367:Neoplasm Staging; D016896:Treatment Outcome; D057832:Watchful Waiting