Elective Neck Dissection in Node-Negative Early-Stage Oral Cancer

In a recent original article published in New England Journal of Medicine D’Cruz et al., reported about the value of elective versus therapeutic neck dissection in node-negative oral cancer [1]. In a prospective, randomized, controlled trial the effect on survival of elective neck dissection (ipsilateral neck dissection at the time of the primary surgery) versus therapeutic node dissection (watchful waiting followed by neck dissection for nodal relapse) in patients with stage T1 or T2 oral squamous cell carcinomas was evaluated. In their article the authors suggested that elective neck dissection improves overall and disease-free survival compared to therapeutic neck dissection after nodal relapse. The results of this study should be discussed critically.