Surgical management of the neck in squamous cell carcinoma of the floor of the mouth.

Nodal involvement in squamous cell carcinoma considerably lowers survival rate. Despite its importance, neck management has still not been adequately explored. The Authors have retrospectively reviewed the records of 112 cases. Unilateral N+ were treated with a homolateral therapeutic and a controlateral prophylactic neck dissection; bilateral N+ were treated with a bilateral thera- peutic neck dissection. On ®rst observation the majority of cases (66.1%) were T1±2. N+ patients accounted for 45.5%. Among Nÿ patients, 21.3% of occult nodal metastases were observed. The 5-year survival rate was 52.7%. With N+ lesions, a radical neck dissection should be performed; the dissection should be performed bilaterally. With Nÿ lesions a prophylactic modi®ed radical neck dissection is recommended in T2±4 lesions.