title: Is level V neck dissection necessary in primary parotid cancer?
abstract: OBJECTIVE
  This study aims to evaluate the pattern of nodal metastasis to level V in parotid cancer and to examine the clinical value of level V neck dissection (LVND).
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Retrospective chart review of 86 patients (47 N0 nodal metastasis [N0] neck and 39 positive nodal metastasis [N(+) ] neck) who received parotidectomy and neck dissection was performed. The prevalence of pathological nodal metastasis in level V neck was evaluated and correlated with locoregional recurrence.
  
  
  RESULTS
  LVND was performed in 10.6% and 28.2% of patients with clinical NO (cN0) and cN(+) neck disease, respectively. The prevalence of pathological positive nodal metastasis was 0% (cN0) and 81.8% (cN(+) ). In patients with cN0 neck, the rate of recurrence in level V was 6%.
  
  
  CONCLUSIONS
  In our patient cohort with predominantly high-grade parotid cancer, LVND was necessary in patients with cN(+) neck because there was a high likelihood for pathologically positive nodal metastasis. In patients with cN0 neck, the rate of recurrence in level V was low enough not to warrant a routine inclusion of LVND.
authors: Department of Otolaryngology/Head and Neck Surgery, University of Pittsburgh Medical Center, Eye and Ear Institute, Pittsburgh, Pennsylvania, U.S.A; Department of Otolaryngology Head and Neck Surgery, National University Health System, Republic of Singapore.
authors: Chwee M
authors: CM
authors: Lim
authors: Mark
authors: M
authors: Gilbert
authors: Jonas T
authors: JT
authors: Johnson
authors: Seungwon
authors: S
authors: Kim
mesh_terms: D000368:Aged; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000517:prevention & control; D009367:Neoplasm Staging; D010306:Parotid Gland / Q000473:pathology / Q000601:surgery; D010307:Parotid Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010414:Pennsylvania; D012042:Registries; D012189:Retrospective Studies
keywords: Nodal metastasis; level V; neck dissection; primary parotid cancer