Evolution of clinically negative neck. Squamous cell carcinoma of oral cavity and faucial arch.

Abstract

The question of whether to electively treat the neck which is clinically negative in patients with squamous cell carcinoma of the oral cavity and faucial arch long has been debated among surgeons and radiotherapists. Some surgeons have found a high incidence of subclinical cancer in the cervical nodes of patients having elective neck dissection, and therefore suggest that radical neck dissection should be done routinely. 5,6 Berger and his co-workers 7 showed that cancer will rarely develop in the electively radiated neck of patients with oropharyngeal and nasopharyngeal cancer, if the tumor dose is 5,000 rads in five weeks or more. Radical neck dissection and radical radiation are not without their complications, and are warranted as an elective treatment only if it can be demonstrated that cervical metastases cannot be successfully managed if they subsequently develop. The policy at the University of Texas MD Anderson Hospital and Tumor Institute, Houston,