Risk-stratified management of the clinically node-negative neck in early-stage oral squamous cell carcinoma: Elective neck dissection versus watch-and-wait with therapeutic dissection.
Eur J Surg OncolAug 5, 2026 (epub)
Shuchismita Chakraborty, Deba P Rath, Yash Vyas et al.
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In 30 seconds
This systematic review evaluated the management of clinically node-negative (cN0) neck in early-stage oral squamous cell carcinoma (OSCC) by comparing elective neck dissection (END) to a watch-and-wait (W&W) approach with therapeutic dissection. END showed improved 3-year overall survival (80.0% vs. 67.5%; HR 0.64, P = 0.01) and disease-free survival (DFS) compared to W&W.
Key findings
- END improved 3-year overall survival at 80.0% compared to 67.5% for W&W (HR 0.64, P = 0.01).
- Disease-free survival was significantly better with END at 69.5% versus 45.9% for W&W (P < 0.001).
- Nodal recurrence rates were lower with END at 15.1% compared to 41.5% for W&W (OR 0.25, P < 0.00001).
- A strict W&W protocol in low-risk patients achieved comparable disease-specific survival.
Why it matters
Understanding the optimal management of cN0 neck in early-stage OSCC is crucial for improving patient outcomes. This study highlights the importance of risk stratification in treatment decisions, potentially guiding clinicians in selecting appropriate management strategies.