Indications for Neck Dissection with Oral Cancers

Clinically/radiologically N+ neck: Modified radical neck dissection (MND) / Radical neck dissection (RND)

Clinically/radiologically N0 neck

  • >20% risk of occult nodes
    • T1 <4mm depth: Watchful waiting
    • T1 >4mm depth, T2-T4: Electively treat neck
  • Elective SND Levels I – IV of ipsilateral neck
  • Convert to MND if suspicious nodes in neck (+/- frozen section)
  • Elective contralateral neck dissection for tumour approaching/crossing midline

D’Cruz AK, Vaish R, Kapre N et al. Elective versus Therapeutic Neck Dissection in Node-Negative Oral Cancer. 2015. N Engl J Med;373:521-9

Index: Clinical Practice Guidelines for Oral Cancer

Resource Appropriate Oral Cancer Guideline Scenarios