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An update on the latest evidence for managing the clinically negative neck (cN0) in oral squamous cell carcinoma
Author(s) -
Brennan PA,
Subramaniam S,
Tsioryannis C,
Green B
Publication year - 2017
Publication title -
oral diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.953
H-Index - 87
eISSN - 1601-0825
pISSN - 1354-523X
DOI - 10.1111/odi.12528
Subject(s) - medicine , neck dissection , sentinel node , surgery , lymph node , biopsy , basal cell , head and neck squamous cell carcinoma , metastasis , radiology , carcinoma , head and neck cancer , radiation therapy , cancer , breast cancer
The single most important prognostic indicator for survival in oral squamous cell carcinoma (OSCC) is the presence of lymph node metastases in the neck. While the treatment of the clinically node positive (cN+) neck is well established, the management of the clinically negative neck (cN0) is controversial. Various strategies have been advocated including close observation including regular ultrasound imaging, elective neck dissection and sentinel lymph node biopsy. Neck dissection surgery is not without potential morbidity with shoulder dysfunction being the main complication. A number of factors are associated with increased risk of neck node metastasis including primary tumour thickness and peri‐neural invasion. A recent prospective randomised trial has found survival benefit following neck dissection even in patients with a cN0 neck at presentation. We discuss the latest evidence for managing the cN0 in OSCC and include our own experience on the role of neck dissection in certain cases.