ABSTRACT
Primary site treatment was by transoral excision without reconstruction, and patients were randomly allocated to either ipsilateral neck dissection or watchful waiting followed by neck dissection in the event of nodal relapse. Primary and secondary endpoints were overall survival and disease-free survival. In terms of overall survival, there were 50 deaths in the elective surgery group and 79. The authors submit complex statistical techniques to demonstrate a statistically significant difference between the two groups at 3 years strongly in favour of the group undergoing neck dissection at the time of primary excisional surgery. A paragraph is devoted to explaining the difference between the incidence of nodal relapse in the therapeutic surgery group versus the elective surgery group, which seems to suggest a difference in their routine histopathological examination of submitted neck dissection specimens. On basic clinical grounds patients were therefore likely to have been under-staged.
