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.