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Because patients with early-stage oral cancers (no clinical signs of spread to lymph nodes) have a 20% to 30% chance of eventually developing nodal disease, most patients undergo either prophylactic lymph node dissection or, less commonly, radiation therapy to the nodal bed. As a result, a substantial number of patients can experience adverse effects from treatment without potential benefits. By minimizing surgical invasiveness, sentinel lymph node biopsy (SLNB) and dissection might reduce morbidity and still allow reliable assessment of nodal disease status. To assess whether the absence of nodal disease as determined by SLNB reliably predicted negative results in other nodes after neck dissection, investigators performed SLNB followed by …