What do systematic reviews say?

PET-CT following chemoradiotherapy (neck dissection only if no/incomplete response) vs Planned neck dissection before or after chemoradiotherapy

PET-CT following chemoradiotherapy (neck dissection only if… showed no clear difference in locoregional recurrence compared with planned neck dissection before or after chemoradiotherapy (moderate certainty).

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes

  3 years
  HR 1.00 [0.94, 1.06]
  1 study · 564 participants
  Moderate

Surgery plus radiotherapy vs Radiotherapy alone

The review found no eligible studies for this question.

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
  Locoregional recurrence: not reported.
  0 studies
  No studies found

Sentinel node biopsy (neck dissection only if biopsy positive) vs Elective neck dissection

Sentinel node biopsy (neck dissection only if biopsy positive) showed no clear difference in locoregional recurrence compared with elective neck dissection (low certainty).

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes

  3 years
  HR 1.04 [0.91, 1.19]
  1 study · 279 participants
  Low

Supraomohyoid neck dissection vs Modified radical neck dissection

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
  Locoregional recurrence: reported but not usable (variable follow-up) (Guo 2014).
  1 study
  GRADE not reported

Elective radical (comprehensive) neck dissection vs Elective selective neck dissection

The review found no eligible studies for this question.

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
  Locoregional recurrence: not reported.
  0 studies
  No studies found

Surgery vs Radiotherapy alone

The review found no eligible studies for this question.

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
  Locoregional recurrence: not reported.
  0 studies
  No studies found

Elective neck dissection (at time of primary tumour resection) vs Therapeutic (delayed) neck dissection

Elective neck dissection (at time of primary tumour resection) probably leads to lower locoregional recurrence compared with therapeutic (delayed) neck dissection (moderate certainty).

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes

  3 years
  HR 0.58 [0.43, 0.78]
  4 studies · 458 participants
  Moderate

Superselective neck dissection vs Elective selective neck dissection

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
  Locoregional recurrence: data not presented usably and inconsistent; Pandey 2018 no difference (3/12 vs 3/20); Rastogi 2018 lower recurrence with superselective (Kaplan-Meier P<0.05); 72 participants (2 RCTs).
  2 studies · 72 participants
  Very low

Surgery plus radiotherapy vs Chemotherapy (chemoradiotherapy)

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes

  oral cavity
  Locoregional recurrence: reported difference between groups not statistically significant (P=0.355), but no useable data; 32 participants (1 RCT, Iyer 2015).
  1 study · 32 participants
  Very low