Elective Neck Dissection - Rational
Rate of occult metastasis in clinically negative neck 20 - 30% using clinical exam and radiographic findings.
Indication - primary lesion with 20% or greater risk of occult metastasis. (7)
Friedman et al. - CT or MRI combined with physical exam rate of occult disease decreased to 12 %.
Suggest lowering of criteria for elective neck dissection. (8)