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OBJECTIVE/HYPOTHESIS:: The utility of elective neck dissection in the management of patients with oral cavity and oropharyngeal cancer who present without neck metastases remains controversial. The study addressed the question of whether elective neck dissection improves regional control and survival in patients with squamous cell carcinoma of the oral cavity and oropharynx presenting with T1/T2 node-negative disease.STUDY DESIGN:: A nonrandomized, uncontrolled retrospective chart review.METHODS:: A nonrandomized, uncontrolled retrospective chart review was performed. Resection of the primary tumor was performed in all patients. The neck was observed in one group, and elective neck dissection was performed for patients in another group.RESULTS:: The study data indicated that elective neck dissection significantly improves regional control and regional recurrence-free survival. Elective neck dissection when compared with observation of the neck did not improve overall survival.CONCLUSION:: Elective neck dissection reduces regional recurrence and may extend disease-free survival. [ABSTRACT FROM AUTHOR]