title: Neck recurrence after level I-IV or I-III selective neck dissection in the management of the clinically N0 neck in patients with oral squamous cell carcinoma.
abstract: BACKGROUND
  Controversy remains regarding extending the level I-III selective neck dissection (SND) to include level IV in the management of the clinically N0 (cN0) neck in patients with oral squamous cell carcinoma (OSCC).
  
  
  METHODS
  Histologic and follow-up data of 87 patients with previously untreated OSCC undergoing I-IV SND and 41 undergoing I-III SND between 2002 and 2006 were reviewed.
  
  
  RESULTS
  Of the 98 I-IV SNDs performed, 4 had involvement of level IV. No relationship between tumor variables and level IV involvement was identified. Survival analysis failed to demonstrate a significant difference between I-III and I-IV SND in terms of developing neck recurrence in the 2 years following surgery.
  
  
  CONCLUSIONS
  Level I-III SND is effective management of the cN0 neck (when coupled with postoperative radiotherapy in selected cases) in patients with OSCC, although it is recommended that a larger prospective study be performed in this field.
authors.affiliation: School of Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK. msbajwa@doctors.org.uk
authors.forename: Mandeep S
authors.initials: MS
authors.lastname: Bajwa
authors.forename: Roddy
authors.initials: R
authors.lastname: McMillan
authors.forename: Owais
authors.initials: O
authors.lastname: Khattak
authors.forename: Mathew
authors.initials: M
authors.lastname: Thomas
authors.forename: Ojas P
authors.initials: OP
authors.lastname: Krishnan
authors.forename: Keith
authors.initials: K
authors.lastname: Webster
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D016001:Confidence Intervals; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009333:Neck / Q000473:pathology; D037981:Neck Dissection / Q000009:adverse effects* / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000209:etiology* / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis