The authors have no funding, financial relationships, or conflicts of interest to disclose.
Head and Neck
When to manage level V in head and neck carcinoma?†
Article first published online: 13 JAN 2011
Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 121, Issue 3, pages 545–547, March 2011
How to Cite
Naiboğlu, B., Karapinar, U., Agrawal, A., Schuller, D. E. and Ozer, E. (2011), When to manage level V in head and neck carcinoma?. The Laryngoscope, 121: 545–547. doi: 10.1002/lary.21468
- Issue published online: 18 FEB 2011
- Article first published online: 13 JAN 2011
- Manuscript Accepted: 17 NOV 2010
- Manuscript Revised: 14 NOV 2010
- Manuscript Received: 22 SEP 2010
- Head and neck carcinoma;
- lymphatic metastasis;
- level V;
- spinal accessory nerve;
- Level of Evidence: 4.
As superselective neck dissection strategy is gaining popularity to minimize postoperative morbidity and better life quality, we investigated the metastatic nodal status of level V neck lymph node group for head and neck squamous cell carcinoma in various primary sites. We have also aimed to display the impact of involvement of other nodal groups on level V.
Retrospective review of histopathologic examination of case series at a comprehensive cancer center.
The study group was composed of 107 patients who underwent a type of neck dissection including level V among 243 patients. The impact of primary site and metastatic nodal status of other levels on metastasis to level V involvement were evaluated.
The most common primary tumor site was oropharynx (n = 43), followed by oral cavity (n = 32), larynx (n = 16), carcinoma of unknown primary (n = 10), and hypopharynx (n = 6). General pathologic N positivity for all levels was 78.3% (76 of 97) when 10 carcinoma of unknown primary patients were excluded. Level V was involved in 13 of 107 (12.1%) patients. Level V was not involved in any patient when the other levels were not involved (0 of 21). Even when considering only N+ patients, the ratio of N positivity for level V is still <20% (13 of 86, 15.1%).
Because level V was not involved in any patient when the other levels were not involved, it might be reasonable to preserve level V especially in clinically and intraoperatively N0 patients. Laryngoscope, 2011