Q) Treatment of No neck in head and neck cancers is
a) Elective lymph node dissection
b) Modified radical lymph node dissection
In patients with a clinically negative neck, the incidence of occult metastases varies with the site, size and thickness of the primary tumour. The high rate of occult cervical metastases (> 20%) in tumours of the lower part of the oral cavity is the main argument in favour of elective treatment of the neck even if it is N0. Several clinical and pathological studies have demonstrated that the pattern of metastatic lymph node metastases occurs in a predictable fashion in patients with oral and oropharyngeal carcinoma.
The risk of metastases increases as one progresses from the anterior to posterior part of the upper aero-digestive tract; from lip (10%) progressing along the tongue (25%), gum (30%), floor of mouth (40%), oropharynx (55%) to hypopharynx (65%). Endophytic tumors, poorly differentiated tumors, and tumors with a greater thickness (tongue and floor of mouth) are more likely to have metastases