Very interesting fact so many lymph nodes in the neck. Every diagnosis and patient dictate a unique treatment but I am most weary of the "surgery only" option. In most cases, with good margins, and low staging, I understand the approach.

BUT, cancer is a bastard and evil and sneaky. With that many nodes, it just seems like a cancer cell can hide anywhere and later attack.

Basing diagnosis on FNA of nodes is another question mark. With so many, how on earth can they really know which ones have cancer? They can't so neck dissection seems very much an educated guess rather than fully science and diagnostic based.

Personally, I'd think really hard about getting some chemo with any surgery only procedure. Just seems like well worth the suffering to improve the mopping up of any stray undetected and hiding cancers.