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Neck dissection has low morbidity & mortality
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END results in a large number of unnecessary surgical procedures and is associated with inevitable morbidity
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Cure rate for neck dissection is decreased if gland enlargement occurs or multiple nodes appear
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Cure rates are no lower if the surgeon waits for the neck to convert from N0 to N1
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It is impossible to provide follow-up necessary to detect the earlier conversion of a neck from N0 to N1
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Careful clinical follow-up will allow detection of the earliest conversion from N0 to N1
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Allowing the neck metastases to develop increases the incidence of distant metastasis
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END removes the barrier to the spread of disease and also has a detrimental immunological effect
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If neck has been entered to remove the primary it is better to perform an in-continuity resection
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Radiation is as effective as neck dissection in N0 neck
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High incidence of occult metastatic disease
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