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

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.

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

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.

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

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.