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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In his commentary, Johnson¹argued that surgical therapy was adequate treatment for patients with limited metastatic disease in the neck (1-2 involved nodes confined by the capsule of the nodes) and that these patients could be spared radiation selective neck dissection but comprehensive neck dissection.

In other words, he appeared to be advocating the most extensive surgery for patients with the least amount of cancer. To me, this seemed no more logical than performing total laryngectomies for T1 supraglottic carcinomas, while reserving voice-conserving procedures for those with more extensive disease.

Bhadrasain Vikram, MD
Bronx, NY

1. Johnson JT. Selective neck dissection in patients with squamous cell carcinoma of the upper respiratory and digestive tracts: a lack of adequate data. Arch Otolaryngol Head Neck Surg. 1998;124:353. FREE FULL TEXT

In reply

I appreciate the opportunity to respond to Vikram's comments. He calls attention to the fact that I have incompletely explained my thinking. I believe that the preponderance of evidence suggests that the classic "functional" neck dissection in which the nodes from zones I to V are removed is adequate treatment for patients with . . . [Full Text of this Article]

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