Conclusion

Several controversies surround the use of END in the treatment of HNSCC. Included are the therapeutic effects of selective procedures and the indications for adjuvant therapies. Ongoing studies are attempting to define the role of SND for the treatment of limited cervical disease. END remains the most accurate tool currently available to stage the neck in HNSCC. Staging provides important prognostic information and targets patients who may benefit from combination therapy.

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Pitman and Johnson—CHAPTER 1

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"A topic ceases to be interesting when it is no longer controversial

The choice of treatment of the neck in patients with cancer of the head and neck has been controversial for decades. In recent years, the focus of that controversy has shifted. The radical neck dissection is no longer the only operation performed when treatment of the neck nodes is necessary. In fact, today, it is the least commonly done type of neck dissection. Currently, one of the greatest controversies centers around the role of the selective neck dissections in the treatment of the NO neck. Interestingly, alongside the decision to perform a selective neck dissection are a number of controversial issues regarding alternative, less invasive methods of staging the cervical lymph nodes, which include imaging studies. The discussion that follows addresses these controversies and analyzes the efficacy of the selective neck dissections.

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