title: Prognostic value of level IV metastases from head and neck squamous cell carcinoma.
abstract: BACKGROUND
  The purpose of this study was to evaluate the prognostic value of level IV metastases in head and neck squamous cell carcinoma (HNSCC).
  
  
  METHODS
  The clinical and histopathological data of 111 patients with HNSCC with pN+ neck who underwent a primary tumor resection with unilateral or bilateral neck dissection were analyzed.
  
  
  RESULTS
  Level IV metastases were histopathologically proven in 33 patients (29.7%). Pulmonary metastases were observed in 12 of 33 patients (36.4%) with level IV metastases, and in 13 of 78 patients (16.7%) without level IV metastases (p = .04). Multivariate analyzes revealed a significant association between level IV metastases and pulmonary metastases (p = .038). However, an influence on overall (p = .65) or disease-free survival (p = .66) was not observed.
  
  
  CONCLUSIONS
  Level IV metastases seem to be a predictive factor for pulmonary metastases but not for overall and disease-free survival in patients with HNSCC.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Philipp University, Marburg, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Hoch
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Philipp University, Marburg, Germany.
authors.forename: Nour
authors.initials: N
authors.lastname: Katabi
authors.affiliation: Institute of Medical Biometry and Epidemiology, Philipp University, Marburg, Germany.
authors.forename: Hanna
authors.initials: H
authors.lastname: Daniel
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Philipp University, Marburg, Germany.
authors.forename: Nora
authors.initials: N
authors.lastname: Franke
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Philipp University, Marburg, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Wiegand
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Philipp University, Marburg, Germany.
authors.forename: Annette P
authors.initials: AP
authors.lastname: Zimmerman
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Philipp University, Marburg, Germany.
authors.forename: Magis
authors.initials: M
authors.lastname: Mandapathil
authors.affiliation: University of Udine School of Medicine, Udine, Italy.
authors.forename: Alfio
authors.initials: A
authors.lastname: Ferlito
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Philipp University, Marburg, Germany.
authors.forename: Afshin
authors.initials: A
authors.lastname: Teymoortash
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016896:Treatment Outcome
keywords: head and neck cancer; level IV; lymph node metastases; prognosis; pulmonary metastases