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. Author manuscript; available in PMC: 2015 May 1.
Published in final edited form as: Oral Maxillofac Surg Clin North Am. 2014 May;26(2):123–141. doi: 10.1016/j.coms.2014.01.001

Table 7.

Risk of occult metastases in oral squamous cell carcinoma considerations for elective neck dissections

Study population Risk Author/Conclusion
Stage I/II clinically N0 Risk of Recurrence

  • Elective neck dissection

  • Observation (no neck dissection)

 1/28 pN0, 1/8 pN+
11/35 (31%)		 Yuen et al. (71 patients)
Elective neck dissection identified
22% occult LN mets and reduced
risk of recurrence
Clinically T1/T2 N0 Tumor Depth of Invasion Risk of Occult Metastases
Tongue < 3 mm 1/23 (4.3%) Zhang et al. ( 65 patients)
≥ 3mm 13/42 (31%) Recc neck dissection when an oral
tongue SCC has a depth of
invasion ≥3 mm
Tongue <4 mm 0/14 (0%) Sparano et al. (45 patients)
≥4 mm 13/18 (41%) Recc neck dissection when an oral
tongue SCC has a depth of
invasion ≥4 mm
FOM ≤1.5mm 1/57 (2%) Mohit-Tabatabai et al.(84 patients)
1.6-3.5 mm
> 3.5 mm		 4/12 (33%)
9/15 (60%)		 Favors neck dissection for floor of
mouth SCC >1.5 mm in thickness

FOM=floor of mouth; Recc=recommendation