F ORMAS ALTERNATIVAS DE EVALUACIÓN La evaluación tradicional se basa en la con-

in patients with cn0 squamous cell carcinoma of the oral cavity, the occult metastatic rate was 22% (50 out of the 224 patients) after a combination of palpation and US +/- ultrasound guided FNAC had been used to stage the neck. In the patients with cT1N0M0, the occult metastic rate was 10% (8 out of the 77 T1 patients), so routine SND I-III might not be necessary.

Selective neck dissection of level i-iii remains the elective neck dissection of choice in cT2-4N0 cases. When frozen section sampling is tumor-positive, it does not seem to be necessary to extend routine perioperative frozen section sampling or neck dissection to levels IV and V, because no metastases were found beyond level III. Therefore the indications for routine perioperative frozen section sampling are limited.

CHAPTER 2

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.1

FDG-PET in the clinically negative neck