Oral Cancer Treatment: Still an Indication for Elective Neck Dissection?

Abstract

Introduction: Oral squamous cell carcinoma has a high incidence and, although elective neck dissection is recommended, the removed nodes frequently present without metastasis. This surgical approach causes disabilities and increases possible surgical complications.

Objective: To evaluate the possibility of a watchful waiting approach in oral cancer.

Methods: We compared 78 patients with clinical and pathological node metastases and their counterparts with pathological node metastases but without evident clinical neck disease. Therefore, we provided a theoretical comparison between the patients who had an elective neck dissection and those who waited until a clinically positive node was evident.

Results: The prognostic factor rates were similar between the groups. Their regional recurrence and mortality rates had no statistical differences.

Conclusion: A watchful waiting policy could be applied to selected oral cancer patients who can undergo a very close follow-up. This option would be more cost-effective and less harmful than elective neck dissection.

Keywords: Epidermoid cancer; Head and neck cancer; Neck dissection; Oral carcinoma.