Primary Tumor Depth of Invasion and Lymph Node Management in Oral Squamous Cell Carcinoma

Inclusion Criteria: * Patients with biopsy-proven oral squamous cell carcinoma with the edition T1or T2 N0 based on TNM staging by the American Joint Cancer Center AJCC 8th edition * The primary tumor has a depth of invasion (DOI) greater than 4 mm * Clinical N0 status confirmed by reasonable parameters includes computed tomography CT, MRI, -Ultrasonography,( US fine needle aspiration in suspected lymph nodes ) * The primary tumor must be reliably resected to a clear margin without the need for entry of the neck for reconstruction Exclusion Criteria: * Patients with T3T4 OCSCC * Proven or suspected positive neck node * Patient with distant metastasis * Patient with gross injury to the neck that precludes proper surgical dissection. * Patient with a history of radiotherapy to the neck * Recurrent cases of OCSCC or recurrent node disease * Patient with previous neck node biopsy or previous neck dissection * Patient with a medical condition or performance that interferes with the surgical intervention as judged by the specialist physician