title: Prevalence of level V metastases in node-positive head and neck squamous cell carcinoma.
abstract: BACKGROUND
  The dissection of level V neck lymph nodes often results in a decline of postoperative quality of life due to shoulder dysfunction and pain. The necessity of level V dissection is debatable. The aim of the present study was to evaluate the prevalence of level V metastases in patients with node-positive squamous cell carcinomas of the head and neck.
  
  
  METHODS
  A review of the clinical and pathological reports was conducted to ascertain the prevalence and distribution of cervical metastases according to neck level V. Statistical analysis was performed using Fisher's exact test.
  
  
  RESULTS
  Level V metastases were found in 19 out of 104 (18.3%) patients. There was only one patient with level V metastases without involvement of other levels. There was no statistically significant correlation between level V lymph node metastasis and several clinical factors.
  
  
  CONCLUSIONS
  It seems to be feasible to omit dissection of level V in patients without clinical evidence for level V disease without compromising oncological safety.
authors: Department of Otolaryngology, Head and Neck Surgery, University Hospital Giessen and Marburg GmbH, Baldingerstrasse, 35033 Marburg, Germany. swiegand@med.uni-marburg.de
authors: Susanne
authors: S
authors: Wiegand
authors: Annette P
authors: AP
authors: Zimmermann
authors: Andreas M
authors: AM
authors: Sesterhenn
authors: Jochen A
authors: JA
authors: Werner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000556:secondary* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009367:Neoplasm Staging; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies