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We read with great interest the recent article in the ARCHIVES by Clayman and Frank¹on the place of selective neck dissection in the elective treatment of the clinically negative neck. The authors have depicted the problem objectively. We are, however, inclined to dispute their conclusion on the value of selective neck dissection from a scientific point of view and would concur with Johnson² that there is a lack of adequate data. In medicine there is a current trend toward more evidence-based decision making, which is mainly directed by epidemiologists, health care providers, and the government. This movement could be regarded as an acceptable limitation of clinical freedom with the aim to provide better care for patients through a more scientific basis. As in many other specialties, a minority of current decisions on head and neck oncology are based on evidence acquired by randomized clinical trials. The remainder of decisions . . . [Full Text of this Article]

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Is Selective Neck Dissection Adequate Treatment for Node-Positive Disease?
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