Oral medicine and oral cancer: elective neck dissection: practice question

A Dentistry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dentistry · Oral medicine and oral cancer: elective neck dissection

Sample item

A man has a 2.5 cm carcinoma of the lateral tongue with 8 mm depth of invasion and a clinically negative neck on CT and ultrasound. How should the neck be managed?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Elective neck dissection with the primary resection

Depth of invasion is the key predictor of occult nodal metastasis in oral carcinoma. When it is more than a few millimetres, an elective selective neck dissection at the time of primary surgery is recommended even if the neck is clinically negative.

Option by option

  • A. Chemotherapy alone to the neck

    Chemotherapy alone does not control nodal disease and is not used for this purpose.

  • B. Neck irradiation only if nodes appear

    Delaying treatment until nodes appear lets disease progress and worsens survival.

  • C. Elective neck dissection with the primary resection (correct)

    Correct. Deep invasion carries a significant risk of occult nodes, so elective dissection is advised.

  • D. Watchful waiting of the neck

    Watchful waiting is reserved for thin tumours where the nodal risk is low.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dentistry question

What is the answer to this Dentistry question?

The best answer is C, Elective neck dissection with the primary resection. Depth of invasion is the key predictor of occult nodal metastasis in oral carcinoma.

Why is "Chemotherapy alone to the neck" not the answer?

Chemotherapy alone does not control nodal disease and is not used for this purpose.

Why is "Neck irradiation only if nodes appear" not the answer?

Delaying treatment until nodes appear lets disease progress and worsens survival.

Why is "Watchful waiting of the neck" not the answer?

Watchful waiting is reserved for thin tumours where the nodal risk is low.

What concept does this question test?

It tests Oral medicine and oral cancer: elective neck dissection in Dentistry. When it is more than a few millimetres, an elective selective neck dissection at the time of primary surgery is recommended even if the neck is clinically negative.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Oral medicine and oral cancer: elective neck dissection?

Learn the dental formula, eruption ages and tooth structure once, as tables. Then use the flashcards and the other Dentistry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.