Micro-metastasis and isolated tumour cells: the span between elective neck dissection versus neck observation in early oral cancer.

Early oral squamous cell carcinoma (SCC) has a propensity for lymph-node metastasis. To address or not to address the neck electively during the ablative surgery has been an ongoing debate. In recent years, some practice-changing trial and systematic reviews have emerged and put to rest the discussion of elective neck dissection versus neck observation. Today elective neck is not a mere staging procedure. It has a definitive survival advantage, but the pathological basis of this advantage has not been elaborated. Understanding this could help answer some of the critical aspects of tumour spread.