Abstract
Surgical management of regional metastases from upper aerodigestive tract malignancies has shifted from the traditional radical resection to more conservative procedures that are tailored to the extent of nodal disease and to the location of the primary tumor. When the primary tumor is treated surgically, a selective neck dissection is now performed routinely in the patient with a clinically negative neck who has a significant risk of developing regional disease. Future directions of research should emphasize clinicopathologic and molecular predictors of occult metastases in the N0 neck to allow selective, therapeutic, and cost-effective treatment of the cervical lymphatics.
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