ASCO GUIDELINES Bundle

Management of the Neck in Squamous Cell Carcinoma of the Oral Cavity and Oropharynx

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7 Patients with oral cavity cancer and pN1 who did not undergo a high-quality neck dissection Patients with oral cavity cancer and pathologic N2 or N3 disease Patients with pathologically node negative (pNO) 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 Ipsilateral Neck Contralateral Neck A contralateral neck dissection should be performed An ipsilateral therapeutic selective neck dissecion should include nodal levels Ia, Ib, IIa, IIb, III and IV. An adequate dissection should inlude at least 18 lymph nodes Dissection of level V may be offered in patients with multi-station disease NO YES cN+ cavity SCC Adjuvant Radiotherapy

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