"A Study of Elective or Therapeutic Neck Dissection in Oral Squamous Cell Carcinoma with N0 neck"

Although there are many reports on the propriety of elective neck dissection in the initial treatment of N0 cases, the results are inconsistent.In this study, we report the significance of elective neck dissection in N0 cases of oral squamous cell carcinoma (OSCC) treated at our department.We included 225 patients who underwent initial surgical treatment for N0 cases of OSCC in our department for 10 years.Of the 225 patients, 88 underwent elective neck dissection including primary tumor resection (elective surgery group), and 137 underwent primary tumor resection alone (therapeutic surgery group).The elective surgery group included 2, 35, 11, and 40 cases with T1, T2, T3, and T4 stages, respectively.The therapeutic surgery group included 64, 68, 2, and 3 cases with T1, T2, T3, and T4 stages, respectively.In the elective surgery group, 32 patients had cervical lymph node histopathological metastasis.In the therapeutic surgery group, 40 patients had subsequent cervical lymph node metastasis.Postoperative adjuvant treatment was performed in 14 and 22 patients in the elective and therapeutic surgery groups, respectively.The 5-year survival rates were 80.7% and 83.9% in the elective and therapeutic surgery groups, respectively, with no significant difference between the groups.This result suggests that there is no difference in prognosis if early detection and treatment of subsequent cervical lymph node metastasis is performed with appropriate follow-up.However, there is still a need to consider the indication for elective neck dissection.