Conclusion
This meta-analysis estimated a pooled rate of occult lymph node
metastases of 11% (99% CI: 0.07-0.17), with specific rates of 12% for
pT3 tumours and 14% of pT4 tumours. Taking into account other pertinent
factors such as the aim of single modality of treatment, the need to
access the neck for reconstructive purposes, and the low morbidity for
highly selective neck dissections, we would advocate that a selective
neck dissection of at least level II should be considered in locally
advanced (T3 and T4) TBSCC or radiotherapy to the upper neck.