Relevance of oropharyngeal cancer lymph node metastases in the submandibular triangle and the posterior triangle apex

Anticancer Res. 2009 Nov;29(11):4785-90.

Abstract

Background: Neck dissection of levels I and IIB is time consuming and can cause several comorbidities. The aim was to analyze whether levels I and IIB need to be dissected in patients with oropharyngeal cancer and clinical N0 or N+ neck.

Patients and methods: A retrospective analysis of 77 patients with oropharyngeal cancer was carried out with evaluation of the incidence of neck node metastasis in levels I and IIB.

Results: None of the patients with cN0 neck had metastases in level I or IIB; 12.8% of the patients with cN+ neck had metastases in level I, 35.1% in level IIA and 25.6% had metastases in level IIB.

Conclusion: Levels I and IIB should be dissected in cN+ neck in order to achieve maximal oncological safety. The preservation of levels I and IIB in cN0 neck seems to be justified in terms of improving functional results and concomitant reduction of operation time.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / surgery
  • Humans
  • Lymph Nodes / anatomy & histology
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis
  • Middle Aged
  • Neoplasm Staging
  • Oropharyngeal Neoplasms / pathology*
  • Oropharyngeal Neoplasms / surgery
  • Retrospective Studies