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Management of the neck in early oral cancers: Is the verdict out?

1 Department of Surgical Oncology, HCG Cancer Center, Head and Neck Services, Karnataka, India
2 Department of ENT Head Neck Surgery, Jawaharlal Nehru Medical College, KLE University, Belgaum, India
3 Department of Surgical Oncology, St. John's Medical College, Bengaluru, Karnataka, India

Correspondence Address:
Vishal U. S. Rao,
Department of Surgical Oncology, HCG Cancer Center, Head and Neck Services, #8 HCG Towers, P. Kalinga Rao Road, Sampangiram Nagar, Bengaluru 560 078, Karnataka
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Source of Support: None, Conflict of Interest: None

The management of patients with the clinically negative neck (N0) in early oral cancers awaits a clear mandate despite growing evidence favoring elective neck dissection. Having a general policy of operating all N0 neck may indeed increase the number of unnecessary neck dissection in the true pathological N0 necks, a more commonly encountered scenario. This controversy needs to be looked beyond statistical evidence to address a larger question to "does the neck truly harbor disease," thus, refining the early age old debate. This article highlights the feasibility of wait and watch policy, while elaborating a stringent algorithm to judiciously select patients in whom the neck may be safely observed.

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