Is dissection of levels 4 and 5 justified for cN0 laryngeal and hypopharyngeal cancer?
CONCLUSIONS
Dissecting levels 2 and 3 and sparing the dissection of level 4 and the contralateral neck when frozen section results are negative are reasonable options for the selective dissection of cN0 necks. Our findings show that dissection of level 5 is considered unnecessary, unless there is overt metastasis.


OBJECTIVE
The level of node involvement and recurrence rates were assessed in cN0 laryngeal and hypopharyngeal carcinoma patients in order to develop appropriate guidelines for the treatment of the neck.


METHODS
A total of 328 cN0 necks operated with selective dissection were reviewed retrospectively. Patients were monitored for at least 24 months and regional recurrences were evaluated.


RESULTS
The prevalence of level 4 occult metastases was 3.4%; 1.5% of them were isolated to level 4. We observed regional recurrence in 5.6% of the necks. No case of metastasis or regional relapse was observed in level 5.
Katilmiş
Hüseyin
H
Department of Otorhinolaryngology and Head and Neck Surgery, Atatürk Research and Training Hospital, Ministry of Health, Izmir, Turkey.
Oztürkcan
Sedat
S
Ozdemir
Ismail
I
Tuna
Bilge
B
Güvenç
Isil Adadan
IA
Ozkul
Yilmaz
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000556:secondary / Q000601:surgery*; D007822:Laryngeal Neoplasms / Q000556:secondary / Q000601:surgery*; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016896:Treatment Outcome