title: Selective neck dissection for clinically node-positive oral cavity squamous cell carcinoma.
abstract: OBJECTIVE
  The treatment of a clinically node-positive (cN+) neck is important in the management of oral cavity squamous cell carcinoma (OSCC). However, the extent of neck dissection (ND) remains controversial. The purpose of our study was to evaluate whether level IV or V can be excluded in therapeutic ND for cN+ OSCC patients.
  
  
  METHODS
  We performed a retrospective chart review of 92 patients who underwent a comprehensive or selective ND as a therapeutic treatment of cN+ OSCC from January 1993 to February 2009.
  
  
  RESULTS
  The incidence rate of metastasis to level IV or V was 22% (16 of 72) on the ipsilateral neck. Of 67 cases without clinically suspicious nodes at level IV or V, 11 cases (16%, 11 of 67) had pathologically proven lymphatic metastasis to level IV or V. Only a nodal staging above N2b was significantly relevant with the higher rate of level IV or V lymph node metastasis (p=0.025). In this series, selective ND, combined with proper adjuvant therapy, achieved regional control and survival rates comparable to comprehensive ND in patients under the N stage of cN2a OSCC.
  
  
  CONCLUSIONS
  In conclusion, level IV and V patients can avoid recurrence under cN2a OSCC.
authors.affiliation: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea.
authors.forename: Yoo Seob
authors.initials: YS
authors.lastname: Shin
authors.forename: Yoon Woo
authors.initials: YW
authors.lastname: Koh
authors.forename: Se-Heon
authors.initials: SH
authors.lastname: Kim
authors.forename: Eun Chang
authors.initials: EC
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D009333:Neck / Q000601:surgery; D037981:Neck Dissection; D009362:Neoplasm Metastasis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016896:Treatment Outcome