Elective Management of the Clinically Negative Neck by Otolaryngologists in Patients With Oral Tongue Cancer

Abstract

Variations in the treatment of the cN0 neck are associated with differences in the frequency of treatment of patients with head and neck cancer by otolaryngologists. Uniformity of care must be established within the otolaryngology community by developing widely accepted evidence-based guidelines and referring patients to surgeons who routinely treat head and neck cancer.

Indications and extent of elective neck dissection in patients with early stage oral and oropharyngeal carcinoma: nationwide survey in The Netherlands

“…As observed in Germany 6 and the United States, 8 the current study of Dutch head and neck cancer centres found no uniform diagnostic and therapeutic strategy for the management of cervical lymph nodes in the clinically negative neck of patients with early oral or oropharyngeal carcinomas. Dünne et al 6 have suggested that a uniform, widely adopted management strategy is the basic prerequisite for the initiation and realisation of multicentre studies.…”

“…In the Dutch national guidelines for treatment of oral cavity and oropharyngeal carcinomas (developed by the Nederlandse Werkgroep Hoofd-Halstumoren), the problem of detecting occult metastases is addressed but solid directives on the management of the clinically negative neck are lacking. 8 Influence of primary tumour factors on decision-making In the present study, the site and size of the primary tumour were the most important clinicopathological characteristics in the decision of whether or not to perform an elective neck dissection. 6 In the United States, a survey of 313 board-certified otolaryngologists found substantial variation in the management of the clinically negative neck in patients with T 2 tongue carcinoma.…”

Management of the clinically negative neck in early‐stage head and neck cancers after transoral resection

“…Many studies, most of them retrospective, have examined this subject with conflicting results; consequently, the debate over the treatment of the node‐negative (N0) neck remains unresolved. A national survey conducted in the United States found a lack of consensus within the surgical community regarding the management of the N0 neck 3. A similar observation was noted in the European survey in Marburg, Germany 4.…”

Elective neck dissection for the management of the N0 neck in early cancer of the oral tongue: Need for a randomized controlled trial

“…Should an END be performed or is a wait and watch (WW) policy safe and adequate? A recent national survey conducted in the United States found a lack of consensus within the otolaryngology community regarding the management of the N0 neck 1. A similar observation was noted in the European survey in Marburg, Germany 2.…”