Oropharyngeal cancer: Indications for treatment of Neck

• Neck can be treated surgically or with primary CRT
• Clinically/radiologically N0 neck
  • Electively treat neck for all T-stages (other than very early/superficial lesions)
  • Tonsil, lateral oropharynx: Ipsilateral elective RT / SND Levels II – IV
  • Base of tongue, posterior oropharynx wall, soft palate: Bilateral elective RT / SND Levels II – IV
  • Convert to MND if suspicious nodes in neck at time of surgery (+/- frozen section)

• Clinically/radiologically N+ neck: CRT / Modified neck dissection (MND) / Radical neck dissection (RND)
• Salvage neck dissection following primary CRT
  • Planned neck dissection or for incomplete response (clinically/CT/MRI/PET) at 6 -12 weeks
  • Recurrence

Index: Clinical Practice Guidelines for Oropharyngeal Cancer

Resource Appropriate Oropharyngeal Cancer Guideline Scenarios