Level llb lymph node metastasis in elective neck dissection of oropharyngeal squamous cell carcinoma

Abstract

This study investigated the oncologic safety of preserving level Ilb lymph nodes in ipsilateral. and/or contralateral elective neck dissection (END) in patients with oropharyngeal squamous cell carcinoma (SCC). Fifty-one oropharyngeal SCC patients who underwent surgery as an initial treatment were reviewed. Twenty-one patients had clinically node negative necks (cNO) while 30 patients had ipsilateral clinically node positive necks (cN+). Of the cNO patients, bilateral or ipsilateral END was performed in 15 and six patients, respectively. For the cN+ cases, ipsilateral therapeutic neck dissection with contralateral END was performed in 24 of 30 patients. In the cNO patients, nodal metastasis to level Ilb lymph nodes was not observed in any ipsilateral (21) or contralateral necks (15). Of the 24 cN+ patients who underwent contralateral, END, two cases (8.3%) showed contralateral. occult [eve[ Ilb lymph node metastasis. Our data suggest that in cNO oropharyngeal. cancer patients, level Ilb lymph nodes may be preserved in ipsilateral and contralateral neck dissection. However, caution is advised when preserving contralateral level Ilb nodes in ipsitateral cN+ cases. (c) 2005 Elsevier Ltd. All rights reserved.