title: Is it necessary to dissect levels I and IIB in hypopharyngeal cancer?
abstract: CONCLUSIONS
  The low incidence of metastases in levels I and IIB in patients with hypopharyngeal cancer in cases of clinical N0 and N+ neck and the fact that all patients with metastases in levels I and IIB received postoperative radiotherapy justifies the preservation of levels I and IIB in patients with hypopharyngeal cancer to improve functional results and reduce the operating time.
  
  
  OBJECTIVE
  Neck dissection of levels I and IIB is technically demanding due to the complex local anatomy and can cause several comorbidities. Therefore the aim of the study was to analyze whether levels I and IIB have to be dissected in patients with hypopharyngeal cancer.
  
  
  METHODS
  This was a retrospective analysis of all patients who underwent primary surgical treatment for hypopharyngeal cancer and neck dissection, with evaluation of the incidence of metastases in levels I and IIB in cases of cN0 and cN+ neck.
  
  
  RESULTS
  None of the patients with cN0 neck but 2/33 patients with cN+ neck had metastases in level I. Metastases in level IIB were detected in 1/14 patients with cN0 neck and 2/36 patients with cN+ neck. All patients with metastases in levels I and IIB received postoperative radiotherapy due to the N2b and N2c status.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, UKGM, Marburg, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Wiegand
authors.forename: Judith
authors.initials: J
authors.lastname: Esters
authors.forename: Hans-Helge
authors.initials: HH
authors.lastname: Müller
authors.forename: Tim
authors.initials: T
authors.lastname: Jäcker
authors.forename: Marion
authors.initials: M
authors.lastname: Roessler
authors.forename: Jochen A
authors.initials: JA
authors.lastname: Werner
authors.forename: Andreas M
authors.initials: AM
authors.lastname: Sesterhenn
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D007013:Hypopharynx / Q000473:pathology / Q000601:surgery; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies