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01-12-2019 | Metastasis | Original Scientific Report

Relevance of Level IIb Neck Dissection in Patients with Head and Neck Squamous Cell Carcinomas

Authors: Seiji Hosokawa, Daiki Mochizuki, Goro Takahashi, Jun Okamura, Atsushi Imai, Ryuji Ishikawa, Yoshinori Takizawa, Takashi Yamatodani, Kiyoshi Misawa, Hiroyuki Mineta

Published in: World Journal of Surgery | Issue 12/2019

Abstract

Background

Cervical nodal metastasis is the most important prognostic factor in patients with head and neck cancers. Unfortunately, nodal dissection at level IIb carries a risk of damage to the spinal accessory nerve. We aimed to determine the prevalence of level IIb metastasis and the relevance of nodal dissection at level IIb in patients with head and neck squamous cell carcinomas.

Methods

During neck dissection, level IIb lymph nodes obtained from 181 patients with head and neck squamous cell carcinomas were removed, processed, and histopathologically examined. All specimens were divided into two groups according to the side (affected and unaffected sides). The number of dissected lymph nodes and prevalence of level IIb metastasis in each group were then determined and compared according to the preoperative clinical N stage (cN0 and cN+).

Results

The study included 158 men and 23 women with a median age of 65 years (range, 17–89 years). The prevalence of pathologically confirmed level IIb metastasis was 0% for clinically node-negative (cN0) necks on the unaffected side and 10.34% for clinically node-positive necks (cN+), with an overall prevalence of 2.4%. There was a significant association between clinically determined and pathologically confirmed node negativity at level IIb.

Conclusion

Our findings suggest that level IIb neck dissection in patients with head and neck squamous cell carcinomas may be required only if preoperative examination reveals multilevel or level IIa metastasis or suspicious level IIb metastasis.

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Title: Relevance of Level IIb Neck Dissection in Patients with Head and Neck Squamous Cell Carcinomas
Authors: Seiji Hosokawa
Daiki Mochizuki
Goro Takahashi
Jun Okamura
Atsushi Imai
Ryuji Ishikawa
Yoshinori Takizawa
Takashi Yamatodani
Kiyoshi Misawa
Hiroyuki Mineta
Publication date: 01-12-2019
Publisher: Springer International Publishing
Keywords: Metastasis
Neck Dissection
Published in: World Journal of Surgery / Issue 12/2019
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-019-05147-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Relevance of Level IIb Neck Dissection in Patients with Head and Neck Squamous Cell Carcinomas

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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