Controversies on the management of the clinically negative neck

C. René Leemans*, Eline J.C. Nieuwenhuis, Jonas A. Castelijns, Gordon B. Snow

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Adequate management of the clinically negative neck is vital and should be balanced between over and undertreatment. Compared to clinical examination ultrasound-guided fine-needle aspiration cytology (USgFNAC) at initial staging can reduce the risk of occult metastases for T1-T2 squamous cell carcinoma of the oral cavity or oropharynx considerably to 20%, which justifies local excision of the tumour and a wait-and-see policy for the neck. SN identification and aspiration did not decrease the false-negative rate, and we have therefore abandoned its use in this setting. Using USgFNAC for follow-up enabled early detection of a significant percentage of neck failures and a high salvage rate with therapeutic neck dissection of 80%. Detecting subclinical neck metastases continues to challenge clinicians and debate continues.

Original languageEnglish
Pages (from-to)621-625
Number of pages5
Issue number6
Publication statusPublished - 2003

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