3
Recommendation 1.2b
➤ An ipsilateral therapeutic selective neck dissection for a clinically
node-positive (cN+) neck should include nodal levels Ia, Ib, IIa, IIb,
III and IV. An adequate dissection should include at least 18 lymph
nodes. Dissection of level V may be offered in patients with multi-
station disease. (Moderate Recommendation; EB-I-B)
Recommendation 1.3
➤ In patients with a cN+ contralateral neck, a contralateral neck
dissection should be performed. In patients with a cN0 contralateral
neck, an elective contralateral neck dissection may be offered in
patients with a tumor of the oral tongue and/or floor of mouth that is
T3/4, or approaches midline. (Moderate Recommendation; EB-I-B)
Recommendation 2.1a
➤ Adjuvant neck radiotherapy should NOT be administered to patients
with pathologically node negative (pN0) or a single pathologically
positive node (pN1) without extranodal extension after a high-quality
neck dissection, unless there are indications from the primary tumor
characteristics, such as perineural invasion, lymphovascular space
invasion, or a T3/4 primary. (Moderate Recommendation; EB-I-B)
Recommendation 2.1b
➤ Adjuvant neck radiotherapy should be administered to patients with
oral cavity cancer and pN1 who did not undergo a high-quality neck
dissection (as defined in recommendation 1.2b).
(Moderate Recommendation; EB-I-B)
Recommendation 2.2
➤ Adjuvant neck radiotherapy should be administered to patients with
oral cavity cancer and pathologic N2 or N3 disease.
(Strong Recommendation; EB-I-B)
Recommendation 2.3a
➤ Adjuvant chemoradiotherapy using intravenous bolus cisplatin
(100mg/m
2
every 3 weeks) should be offered to patients with
oral cavity cancer and extranodal extension in any positive node,
regardless of the extent of the extranodal extension and number
or size of involved nodes, and no contraindications to high-dose
cisplatin. (Strong Recommendation; EB-H-B)
Treatment
