Outcome of Observing the N0 Neck Using Ultrasonographic-Guided Cytology for Follow-up

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Abstract
ONE OF the most important tumor-related prognostic factors in head and neck squamous cell carcinoma is the presence of metastases in the cervical lymph nodes.1 Great controversy exists about the proper management of the neck if no lymph node metastases are detected. In most institutions the neck is treated electively if the estimated risk of occult metastasis exceeds 20%.2 As a consequence, most patients with oral, oropharyngeal, hypopharyngeal, or supraglottic laryngeal squamous cell carcinomas qualify for elective treatment. Only in patients with small and superficial primary carcinomas with a risk of occult metastases well below 20% in whom the neck is not entered for excision of the primary carcinoma or reconstruction of the defect is the neck not routinely treated.

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