The conditions indicating an elective neck dissection for oral cancers

The conditions under which an elective neck dissection for oral cancer is indicated were determined, with reference to outcomes. We retrospectively reviewed 42 patients who underwent supraomohyoid neck dissection (SOHND), and 52 patients who underwent conservative neck dissection (CND), between 1989 and 1999. Histopathologically positive lymph nodes (pN+) were found in 14.3 % (6 of 32 patients) at SOHND, and in 55.6 % (10 of 18) at CND, in patients with no clinical findings of metastasis (N0) . There was no significant difference in the 5-year survival rates between SOHND and CND patients. In both SOHND and CND cases, however, patients who had responded well to preoperative treatment had better survival rates than other patients. Metastases of level N or V in patients who had N1, 2 or pN+ were recognized in mesopharyngeal cancer and oral canner invading the pharyngeal area. In the cases in which preoperative treatment was effective, SOHND was indicated as the elective neck dissection of choice. Conservative neck dissection should be performed in cases of oral cancer invading the pharyngeal area.