Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Elective Versus Therapeutic Neck Dissection in the Treatment of Early Node Negative Squamous Cell Carcinoma of the Oral Cavity
Brief Summary: Cervical nodal metastasis is the single most important prognostic factor in head and neck cancers. Appropriate management of the neck is therefore of paramount importance in the treatment of these cancers. While it is obvious that the positive neck must be treated, controversy has always surrounded the clinically node negative neck with respect to the ideal treatment policy.The situation is difficult with regards to early cancers of the oral cavity (T1/T2). These cancers are usually treated with surgery where excision is through the per-oral route. Elective neck dissection in such a situation is an additional surgical procedure with its associated costs, prolonged hospitalization and may be unnecessary in as high as 80% of patients who finally turn out to be pathologically node negative. Should the neck be electively treated or there be a wait and watch policy? Current practice is that the neck is always addressed whenever there is an increased propensity to cervical metastasis or when patient follow-up is unreliable.

There is clearly a need therefore for a large randomized trial that will resolve the issue either way once and for all.

Primary Objective:

To demonstrate whether elective neck dissection (END) is equal or superior to the wait and watch policy i.e.

therapeutic neck dissection (TND) in the management of the clinically No neck in early T1 /T2 cancers of the oral cavity.

Secondary Objective:

1. Does Ultrasound examination have any role in the routine initial workup of a node negative patient?
2. How are patients ideally followed up -does sonography have a role or is clinical examination sufficient.
3. Is assessment of tumor thickness by the surgeon at the time of initial surgery accurate -Is there a correlation
4. Identify histological prognostic factors in the primary that may help identify a sub-set of patients at an increased risk for cervical metastasis.


Options:
A: Arm Label: Ligusure assisted neck dissection; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Neck dissection | Arm Label: Conventional neck dissection; Type: OTHER; Interventions: Procedure: Neck dissection | Intervention Type: PROCEDURE; Name: Neck dissection; Assigned to Arm(s): Conventional neck dissection, Ligusure assisted neck dissection
B: Arm Label: Wait and Watch; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Therapeutic Neck Dissection | Arm Label: Elective Neck dissection; Type: EXPERIMENTAL; Interventions: Procedure: Elective neck dissection in early oral cancer | Intervention Type: PROCEDURE; Name: Elective neck dissection in early oral cancer; Assigned to Arm(s): Elective Neck dissection | Intervention Type: PROCEDURE; Name: Therapeutic Neck Dissection; Assigned to Arm(s): Wait and Watch
C: Arm Label: Surgery and radiotherapy; Type: NO_INTERVENTION; Interventions: N/A | Arm Label: TPF induction chemotherapy; Type: EXPERIMENTAL; Interventions: Drug: TPF induction chemotherapy | Intervention Type: DRUG; Name: TPF induction chemotherapy; Assigned to Arm(s): TPF induction chemotherapy
D: Arm Label: A; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Fluorescence visualization device | Arm Label: B; Type: EXPERIMENTAL; Interventions: Procedure: Fluorescence visualization device | Intervention Type: PROCEDURE; Name: Fluorescence visualization device; Assigned to Arm(s): B | Intervention Type: PROCEDURE; Name: Fluorescence visualization device; Assigned to Arm(s): A

Answer: B