T1/2N0 op cancer and neck dissection

[Ray D. Ayshun]

Does anyone know the data that informed the decision by the nccn to be +/- on elective neck dissection in t1/2n0 p16+ op cancer? Was surprised by this rec, or lack thereof.

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[thecarbonionangle]

Surgeons have a lot of power.

 

[gmsquid]

The only way that would be allowed is if you need rt anyways based on the primary site in clinically node negative. This should be clarified.

 

[kimplera]

The only way that would be allowed is if you need rt anyways based on the primary site in clinically node negative. This should be clarified.

agree

 

[Ray D. Ayshun]

I don't disagree. It's pretty clear, I think, on the guidelines, that p16- gets at least an ipsi dissection while it's optional in p16+. No adjuvant anything if no "adverse features.". Iow, the nccn recommends radical tonsillectomy alone for p16+ t1n0 tonsil cancer. None of us may agree, but I'm wondering why it says that.

 

[seper]

That would be a huge mistake not to address the neck for a T2 tumor. Not aware of any data to support it.

 

[evilbooyaa]

Seems like an oversight. I agree with others in saying the neck needs to be evaluated in every OPhx patient getting surgery.

 

[Ray D. Ayshun]

Seems like an oversight. I agree with others in saying the neck needs to be evaluated in every OPhx patient getting surgery.

Presuming they get to me/us, the neck will be addressed. Otoh, there will be a lot of nononcologic ents out there just removing the primary with the backing of the nccn. Perhaps the argument is the necks were addressed with a pet