The lymph node metastasis in the neck is a critical prognostic factor in oral cancer. Crude and ineffective attempts had long been performed to remove cervical lymph nodes at the time of resection of the primary tumor. In the early 1800s, however, complete removal of neck metastases was considered impossible, and the excision of individual lymph node metastases was usually performed. Then, limited regional neck dissections, including normal tissues such as submandibular gland, were attempted. During the late 19th and early 20th century, a systemic approach to anatomically “en bloc” removal of cervical lymph node metastases was developed. This development enabled really curable surgery of neck lymph node disease, and the systemic method was called “radical neck dissection” in honor of this great advancement. Now, this history of the development of neck dissection is abundant in suggestion to advance the management of neck lymph node disease in the future.
In this article, the factors of “curability” of neck dissection are reconsidered and the possible developments of future neck dissection are discussed. Additionally, our selective neck dissection is shown as an example of an advanced method of neck dissection.
