The medical records of 967 patients treated with a modified neck dissection were carefully reviewed, and the data were collected and statistically analyzed. For a primary tumor in the oral cavity or oropharynx, a supraomohyoid neck dissection was adequate treatment for the neck that was both clinically staged N0 or N1 and pathologically staged N1 without evidence of extracapsular invasion. For primary tumors in the larynx and hypopharynx, an elective bilateral anterior neck dissection is considered proper treatment if the nodes are not multiple or if connective tissue disease is not present. A functional neck dissection is effective neck treatment regardless of the primary site or stage of the disease. The selective use of postoperative radiotherapy can more effectively decrease the incidence of neck recurrence compared with surgery alone in patients with multiple positive nodes, a node more than 3 cm in size, or nodes with extracapsular invasion.
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