Lee....a non-professional opinion here....Since they have already found several involved nodes, I would personally not be comfortable NOT having the dissection, for two reasons: 1.the removal of other possibly cancerous nodes, perhaps with micro-mets that do not show up on the scans, and 2.the removal of the pathway for metastasis, since your tumor was judged to be poorly differentiated.

I feel that perhaps for a T1N0M0 tumor, the decision might be more difficult.

My own tumor was dx'd as a T2N0M0, because of its size and the length of time it had been there (overlooked and allowed to grow without interference!) I was very happy that my surgeon suggested the ND, and I have not regretted it, though I have some aftereffects from it. It gives me a great deal of peace of mind knowing that my nodes were clear (as far as they know) and that the pathway has been interrupted (as far as they know.)

Just my two cents' worth. If it were my neck, I'd follow their suggestions and not try to second-guess them.

Of course, it's easy for me to say....It's NOT my neck, and my ND was done at the time of my original surgery, and I surely would not look forward to another surgery. I would still do it, though.